Talk:Book - Extra-uterine pregnancy - 1921
Publication date 1921
https://archive.org/details/extrauterinepreg00schu
Index
Abderhalden reaction in ectopic pregnancy, 126
Abdominal lesions, not connected with the ectopic pregnancy when (under operation, management of, 168
Abdominal pregnancy, complicated by eclampsia, no
— ■ extraperitoneal, 82
— following normal uterine implanta tion, after rupture of uterus, 83
— primary, causes of, 31
— secondary, following tubal rupture
or abortion, 42
— secondary to primary ovarian
pregnancy, 44
— symptomatology and diagnosis of,
146
— termination of, 82
Abdominal symptoms in extra-uterine pregnancy, 133
Adenomyoma of the uterus, ectopic pregnancy occurring in gland spaces of, 112
Adhesions, peritubal, causing extrauterine pregnancy, 23
Adipocere, diagnosis of, 147
Amenorrhea, in ectopic pregnancy, 122, 123
Anemia, post-operative treatment of, 171, 172
Anteflexion of uterus, 132
Apoplexy, ovarian, 113
Appendicitis, case of, in combination with an unruptured tubal pregnancy, 109
Blood picture, in extra-uterine pregnancy, 133
Blood pressure in extra-uterine pregnancy, 134
Breast changes, in ectopic pregnancy,
125 Broad ligament pregnancy, 39, 40
Cardiac failure, post-operative treatment of, 172
Casts, decidual, of extra-uterine pregnancy, See Decidual casts.
— ■ — of membranous dysmenorrhea, 67
— menstrual, 67
Cervical pregnancy, criteria of, in
— definition and classification of, in
— frequency of, in
— 'primary and secondary, in
— terminations of, in
Cervix, softening of, in ectopic pregnancy, 125
Cholecystitis, differentiated from ectopic pregnancy, 155
Chorioepithelioma of tubes, resulting from tubal pregnancy, 84
Combined intra- and extra-uterine pregnancy, 19, 108
Cornual pregnancy, See Interstitial
Decidua, formation of, from extrauterine pregnancy, 85
— — in tubes, 53, 54
— importance of, in producing a nor mal implantation, 88 — 'passage of, in diagnosis of ectopic pregnancy, 132
— use of term, 54
Decidua vera, development of, in uterus, due to extra-uterine pregnancy, 62
— relation of decidual casts and, to
extra-uterine pregnancy, 63 Decidual casts, of extra-uterine pregnancy, description of, 66
— — -diagnostic errors from examina tion of, 65 — ■ — 'passage of, in diagnosis of ectopic pregnancy, 64, 132
— of membranous dysmenorrhea, de scription of, 6y Decidual masses in the omentum, etiology of, 85
Decidual reaction in tubes, as cause of extra-uterine pregnancy, 25, 50
Ecchyesis, See Extra-uterine Pregnancy
Eclampsia, complicating extra-uterine pregnancy, no
Ectopic pregnancy, See Extra-uterine Pregnancy
Electricity, in treatment of ectopic gestation, 15
Embryo, death of, with formation of tubal mole, as termination of ovarian pregnancy, 35
— fate of, in extra-uterine pregnancy,
87 ■ — -normal and pathological, 88
— percentage that goes on to full term,
88 Extra-uterine pregnancy, abdominal,
complicated by eclampsia, no
extraperitoneal, 82
— ■ — following normal implantation of
ovum, after rupture of uterus, 83
primary, causes of, 31
'secondary, 42
secondary to primary ovarian
pregnancy, 44 — ■ — symptomatology and diagnosis of,
146 termination of, 82
— advanced, common forms of, 80 pathology of, 79
placental attachment in, 82
— i — question as to whether fetal development may continue uninterrupted, 81
treatment of, 173
'when fetus is known to be
dead, 176
— age incidence of, 19
— anatomicopathological groups for
diagnosis of, 119
— before any bleeding takes place into
the tubal wall or the peritoneal cavity, symptomatology of and difficulties of diagnosis, 120, 121
— with beginning tubal abortion or a
minute rupture, permitting a minute quantity of free blood to come in contact with peritoneal surfaces, diagnosis and symptomatology of, 121
Extra-uterine pregnancy, bimanual examinations for, importance of care and gentleness in, 132
— broad-ligament, 39, 40
— ■ causes of, accessory tubes, 25
anomalies of tubal lumen, 25
constriction resulting from pressure of a tumor of neighboring structures, 24
decidual reaction in tubes, 25,
50
■difficulties in arriving at, 22
— ■ — external migration of the ovum,
27, 51
gonorrhea, 24
— ■ — identical in both tubes, 101
— ■ — inflammatory, 30
— ■ — interference, 23
— ■ — of interstitial pregnancy, 70
— ■ — mechanical or postinflammatory obstruction to ova, 29, 50
monstrous or deformed ova,
29
— ■ — 'obstruction of tubal lumen from within, 24
■ obstruction of tubal lumen from
without, 23
— ■ — of ovarian pregnancy, 31
' peritubal adhesions, 23
■ pre-existing pelvic disease, 129
— ■ — previous operations, 130
— ■ — ■ previous conservative gynecological operations, 23
of primary abdominal, 31
— — salpingitis, 24
— ■ — ■ Schil's theory, failure of unstriped muscle fibers of tube to contract, 29
secretion by tube of substances
toxic to ovum, impairing its vitality and ability to progress, 29
sterility, 127
'Summing up of, 29
■ tubal polyps, 28, 50
— ■ — -tumors of the tube, 27
— cervical, in criteria of, ill
'definition and classification of,
ill — ■ — frequency of, 111
■ primary and secondary, in
— ■ — -terminations of, in
INDEX
181
Extra-uterine pregnancy, co-existing with intra-uterine, 19, 108
— - comparative results with normal and with pathological embryos, 88
— complicated, 109
diagnosis of, 147
by eclampsia, HO
by fibroid tumors of uterus, 109
by inflammatory disease, 109
by toxemias of pregnancy, no
— cornual, See Interstitial
— decidual cast of, description of, 66 diagnostic errors from examination of, 65
passage of, in diagnosis, 64,
132
— definition of, 17
— diagnosis of, abdominal pregnancy,
146
adipocere, 147
amenorrhea, 122, 123
anatomicopathological groups for,
119 in beginning tubal abortion or
with a minute rupture, permitting
a minute quantity of free blood to
come in contact with peritoneal
surfaces, 121 in cases without any leakage of
blood into the abdominal cavity,
difficulties and symptomatology of,
120 ■ from character of menstrual flow,
122, 123
in complicated cases, 147
concomitant signs of pregnancy,
124
Abderhalden reaction, 126
anteflexion of uterus, 126,
132
breast changes, 125
■ — enlargement of uterus, 125,
132
frequency of urination, 126
increased pigmentation, 125
morning nausea and vomiting,
125
softening of cervix and enlargement of uterus, 125, 132
difficulties of, 118, 119
— ■ — evidences upon which correct conclusion may be reached, 121
Extra-uterine pregnancy, diagnosis of,
findings on general examination
of patient, 131 — ■ — ■ — abdominal, 133
— ■ blood picture, 133
blood pressure, 134
— • — ■ — -enlargement of uterus, 125,
132
— ■ -Hegar's sign, 132
— ■ — ■ — -passage of decidua or decidual
casts, 132
■ — pelvic mass, 131
— pulse, 133
— ■ temperature, 133
first steps in, 118
— ■ — -with frank rupture of sac or tubal
abortion, 136
— asthenic group, 136
— ' — ■ — sthenic group, 138
— ■ — -hemorrhage, character of, 122 124 -histological, 157
— — -history, 122
— — ■ importance of care in bimanual
examinations, 132
— — interstitial, 143
— -long existing and untreated ectopic gestation, 141
■ — hematocele, 141
■ — lithopedion or adipocere, 147
— ■ — ■ — tubal mole, 142, 143
■ — other than tubal, 143
'Ovarian pregnancy, 145
-pain of interstitial forms in contradistinction to that of tubal, 1 43 .
pain in pelvis as most important
and constant sign of, 126
by palpation, 121
previous history, 127
— ■ — ■ — general health and medical history of patient, 130
-pre-existing pelvic disease, 129
— — ■ — previous operations, 130 — sterility, 127
tubal mole, 141
— differential diagnosis of, from acute
salpingitis, 151
general divisions for, 119
from hemorrhage from tube or
ovary, not in relation to pregnancy, 148 from ovarian cysts, 152
182
INDEX
Extra-uterine pregnancy, differential diagnosis of, from retroversion of the normally pregnant uterus, 153
— . — from ruptured gastric ulcer, renal colic, cholecystitis, etc., 155
from uterine abortion, 148
— , — various forms indistinguishable after rupture, 145
— 'extraperitoneal abdominal, 82
— fate of embryo in, 87
— fate of fetus in, summarization of,
96
— fetuses that develop to full term,
deformities of, 88, 89
— — normal, 89
— frequency of, age incidence, 19
'Constantly increasing, 17
— explanation of, 18
figures showing absolute relation
of extra- to intra-uterine pregnancy, 18
of interstitial, 69
.old statistics, 17
— • — of ovarian cases, 83
race incidence, 19
.relative, of various forms, 21
— frequency of recurrence of, 101
— histological diagnosis of, 157
— history of, Bain's operation, for
long-retained fetus (1540), 5
Campbell's Memoir (1842), 11
'Case of Albucasis (nth century),
1, 2 — . — case of Bard, America (1759), 9
'case of Baynham, 10
case of Calvo, France, 1714, 6
case of Cornax ( 16th century) , 4
case of Felix Platerus (1594), 7
case of Mauriceau (1669), 7
case of Nufer (1500), 4
case of Primrose (1594), 6
— . — case of Riolan (1604), 6 case of Schmitt, interstitial pregnancy, 10 — — cases of, in America, from 1791
to 1846, 10 first absolutely definite case
(1594), 6
first case of tubal gestation with
rupture, 1604, 6
first recorded case (nth century), 1
in America (1759), 9
Extra-uterine pregnancy, history of, increased interest in, in America, from 1846, 10
-lithopedion of Sens (16th century), 3
— > — monograph of Dezeimeris (1837), 10
— ■ — 'Ovarian pregnancy, 12
— ■ — 'Parry's work (1876), 11
Pierre Dionis on (1718), 9
Tait's work, 12
— ■ — 'Unknown to ancients, I
'varieties of, 10
— ■ — 'Werth's studies, 12
— history of treatment for, 12
— ■ — 'in early rupture of tubal pregnancy, 12
— ■ — 'electricity, 15
gastrotomy, 14
.laparotomy dating from 1500,
12
— 1 — Parry on, 12
— ■ infected and suppurative cases of, treatment of, 176
— 'interstitial, diagnosis of, 143
etiology of, 70
— ■ — first recorded case of, 10
— ■ — frequency of, 69
groups of, 70
— ■ — illustrative cases of, 71
— ■ — ■ pain of, in contradistinction to that of tubal pregnancy, 143
— 1 — pathology of, 69
— • — 'rupture of, 143
— — ■ symptomatology and diagnosis of,
143 terminations of, 70
— — — by gradual growth of fetus
into uterine cavity, 41 treatment of, 172
— intraligamentary, 44
— mortality of, 177
— onset of, general form of, 134
— ovarian, causes of, 31 — 1 — diagnosis of, 145 duration of, 76
first case diagnosed as, 12
frequency of, 73
pathology of, 73
placentation in, 75
rupture of, 77
terminations of, 34
treatment of, 173
INDEX
183
Extra-uterine pregnancy, ovarioabdominal, 44
— placentation in ovarian pregnancy,
— primary abdominal, causes of, 31
— prognosis of, 177
— question of removal of non-pregnant
tube as routine procedure in operation for, 102
— race incidence of, 19
— recurrent, cause of, 102
frequency of, 101
interesting case of, 103
for third time, instances of, 103
— relation of uterine decidua and de cidual casts to, 63
— repetition of, 19
— results of fetal death, without sur gical removal, lithokelyphopedion,
92
lithokelyphos, 92
lithopedion, 91
skeletonization, 89
suppuration, 89
— ruptured, diagnosis of, 136
due to bimanual examinations
without sufficient care, 132 simulated by hemorrhage from
ovary or tube, 113 simulated by hemorrhage from
rupture of an apparently normal
graafian follicle, 113
— ruptured tubal, delayed surgical in tervention, 15
electricity in treatment of, 15
first American operation for, 15
gastrotomy in treatment of, 14
hemorrhage from ovary or tube
simulating, 113
history of treatment for, 12
immediate laparotomy the rule
today, 16 .Parry's work on, 12
— secondary abdominal, 42
— symptomatology of, abdominal, 133
of abdominal pregnancy, 146
amenorrhea, 122, 123
in beginning tubal abortion or
with a minute rupture, permitting a minute quantity of free blood to come in contact with peritoneal surfaces, 121
blood picture, 133
Extra-uterine pregnancy, symptomatology of, blood pressure, 134
.in cases without any leakage of
blood into abdominal cavity, 120
— — character of menstrual flow, 122,
123 — ■ — concomitant signs of pregnancy,
124
Abderhalden reaction, 126
breast changes, 125
. — enlargement of uterus, 132
— . ■ frequency of urination, 126
— ■ increased anteflexion of uterus,
126
increased pigmentation, 125
morning nausea and vomiting,
125
softening of cervix and enlargement of uterus, 125
— . — evidences upon which a correct conclusion may be reached, 121
— . — with frank rupture of sac or tubal abortion, 136
generally one of a subacute disease rather than one of fulminant type, 134
hemorrhage, character of, 122 124
of interstitial forms, 143
in long existing and untreated
cases, hematocelej tubal mole, lithopedion formation, etc., 141
pain in pelvis most important and
constant sign, 126
— ■ — passage of decidua or decidual casts, 132
pelvic mass, 131
— —pulse, 133 .temperature, 133
— terminations of, 135
■ in abdominal cases, 82
of cervical, in
by death of embryo with the formation of tubal mole, 35
end results, hematocele, 44, 77
'resorption of products of gestation, 44
— . 'terminal changes, 46
• — tubal mole, 44
gradual growth of fetus into uterine cavity, in cases of interstitial pregnancy, 41
Extra-uterine pregnancy, termination
of, growth and development of
fetus to full term, while still confined in tube, 41
hematocele, 44, yy
in interstitial cases, 70
primary, 33
by rupture of the pregnant tube,
37 between the folds of the broad
ligament, 39
into the peritoneal cavity, 37
secondary, abdominal pregnancy,
secondary to primary ovarian
pregnancy, 44
intraligamentary pregnancy, 44
■ — ovario - abdominal pregnancy,
44
secondary abdominal pregnancy, 43
tubo-abdominal pregnancy, 42
tubo-ovarian pregnancy, 43
— ■ — by tubal abortion, 35
tubal rupture, 57
— 'tissue changes resulting from, 84
chorioepithelioma, 84
— • — decidua formation, 85
— 'treatment of, in advanced cases, 173
when fetus is known to be
dead, 176
after rupture of sac or tubal abortion, with intra-abdominal hemorrhage, 162
— ■ — after rupture, when surgical facilities are available, closure of the incision, 168
■ — expectant plan of treatment,
163, 164
indications for delayed surgical intervention, 173
in interstitial cases, 172
management of abdominal
lesions not connected with the ectopic pregnancy, 168
— ■ management of the affected
tube, 166
management of free blood and
clots in the abdominal cavity, 166
management of the remaining
tube, 167
■ operation, regardless of condition of patient, 163, 165
operative procedure, 165
Extra-uterine pregnancy, treatment of, after rupture, in ovarian cases, 173
postoperative, 171
— technic of the laparotomy, 169
two indices of patient's condition, 165
— "vicious catch phrases" used in
determining, 164
— ■ — ■ before rupture has occurred, 161
by electricity, 15
by gastrotomy, 14
for hematocele, 176
history of, See History of treatment of
in infected and suppurative cases,
176
— ■ — management of certain phases of the condition, 161
— triplet, 106
— case of Mauriceau (1669), 7
— — case of Riolan (1604), 6
causes of, external migration of
ovum, 51 mechanical or postinflammatory obstruction to ova, 50
Pierre Dionis on (1718), 9
Regnus Graaf and others, 8
comparative results with normal
and with pathological embryos, 88
■ complicated, 109
decidua in, formation of, 54
decidual reaction causing, 52
first reported case of (1604), 6
history of treatment of, 12
mode of implantation of ovum in
tubes, 52 — ■ — 'pain of interstitial in contradistinction to that of, 143
— — ■ placentation in, 55
process of, in advanced cases, 59
See also Tubal Pregnancy and
Tubal Rupture
— tubo-abdominal, 42
— tubo-ovarian, 43
— twin, 104
diagnosis of, 105
— 1 — 'unilateral, characteristic case of,
105
— unique forms of, cervical, in in gland spaces of an adenomyo ma of the uterus, 112
— uterine changes produced by, de velopment of decidua vera, 62
Extra-uterine pregnancy, uterine
changes produced by, increased
size, 62
involution, 62, 63
uterine bleeding, 62
— varieties of, 10, 17, 19
Kelly's table showing changes of
primary to secondary forms, 21
primary, 20
relative frequency of, 21
secondary, 20
Fallopian tubes, accessory, causing extra-uterine pregnancy, 25
— action of trophoblast, 54
— active peristaltic powers of muscu lar layers of, 48
— anatomy of, 47
— boundaries of gestation sac, 55
— chorioepithelioma of, resulting from
tubal pregnancy, 84
— decidua in, formation of, 53, 54
— decidual reaction in, as cause of ex tra-uterine pregnancy, 25, 50
— direction of current produced by
cilia of, 47
— implantation of ovum in, always ac companied by excessive amount of
hemorrhage, 54
centrifugal, 54
columnar, 53
intercolumnar, 54
mode of, 52
resulting processes, 56
— place of meeting in, of spermato zoon and ovum, 53
— processes of infection in, 48
— situation of, 47
— susceptibility of mucosa of, to in vasion and damage by infective processes, 48
— trophoblast cells, 55
— tumors of, causing extra-uterine
pregnancy, 27, 50 Fetuses in extra-uterine pregnancy, deformities of, 88
— fate of, 96
— normal, 89
— results of death of, without surgical
removal, lithokelyphopedion, 92, 93 lithokelyphos, 92
— — lithopedion, 91 skeletonization, 89
Fetuses in extra-uterine pregnancy, results of death of, without surgical removal, suppuration, 89
— summarization of fate of, 96 Fibrinoid substance, formation of, 54 Fibroid tumors of uterus, complicating
tubal pregnancy, 109 Follicular hemorrhage, 113
— cause of, 115
Gastric ulcer, ruptured, differentiated from ectopic pregnancy, 155
Gastrotomy, for ruptured tubal pregnancy, history of, 14
Gestation sac, boundaries of, in tubes, 55
Gonorrhea, causing extra-uterine pregnancy, 24
Hegar's sign, 132
Hematinemia, as diagnostic sign of
ruptured ectopic pregnancy, 138 Hematocele, definition of, 78
— etiology of, 77
— infected, 45
— pathology of, jy
— real gravity of, 79
— resulting from extra-uterine preg nancy, 44
— secondary rupture of, 79
— size of, 78
— solitary, 45
— symptomatology and diagnosis, 141
— treatment of, 176
Hematoma, ovarian, 113
Hemorrhage, of extra-uterine pregnancy, amount of, in tubal abortion, 61, 62
character of, 122-124
— from graafian follicle, 115
apparently normal, 113
^causes of, 115
— from ovary, causes of, 113
diagnosis of cause of, 115
occurrence of, 113
pathology of, 115
from ovary or tube, simulating
ruptured ectopic pregnancy, 113
— relative amount of, in cases of tubal
rupture and tubal abortion, 39
— from tube, causes and occurrence of, • 114
diagnosis of cause of, 115
Inflammatory disease, complicating
extra-uterine pregnancy, 109 Interstitial pregnancy, diagnosis of,
143
— etiology of, 70
— first recorded case of, 10
— frequency of, 69 relative, 70
— groups of, 70
— illustrative cases of, 71, 72., 143
— pain of, in contradistinction to that
of tubal pregnancy, 143
— pathology of, 69
— rupture of, 143
— symptomatology and diagnosis of,
143
— terminations of, 70
by gradual growth of fetus into
the uterine cavity, 41
— treatment of, 172 Intraligamentary pregnancy, 44
Jaundice, as diagnostic sign of ruptured ectopic pregnancy, 138
Laparotomy, for ruptured ectopic pregnancy, history of, from 1500, 12
— ■ — technic of, 169
Lithopedion, age of, 93
— definition of, 91
— diagnosis of, 147
— frequency of, 92
— length of time carried, 92
— size of, 93
— typical case of (Maier's), 95
— ultimate result of formation of, 93 Lithokelyphopedion, 92
— genesis of, 93
— typical case of, 94 Lithokelyphos, 92
Membranous dysmenorrhea, decidual cast of, description of, 67
Menstrual casts, description of, 67
Menstrual flow, diagnosis of ectopic pregnancy from character of, 122, 123
Morning nausea and vomiting, in ectopic pregnancy, 125
Nausea and vomiting in ectopic pregnancy, 125
Ovarian apoplexy, 113 Ovarian cysts, differentiated from ectopic gestation, ruptured, 152 Ovarian hematoma, 113 Ovarian hemorrhage, causes of, 113
— diagnosis of cause of, 115
— occurrence of, 113
— pathology of, 115
— simulating ruptured ectopic preg nancy, 113 Ovarian pregnancy, causes of, 31 — ■ diagnosis of, 145 — - duration of, 76
— first case diagnosed as, 12 — > frequency of, 73
— 'pathology of, 73
— * placentation in, 75
— -f rupture of, 77
—^terminations of, 34
death of embryo with the formation of tubal mole, 35
by resorption of the ovum, 34
secondary, abdominal pregnancy,
secondary to primary ovarian pregnancy, 44
ovario-abdominal pregnancy, 44
tubal abortion, 35
— treatment of, 173
Ovarian rupture, followed by ovarioabdominal pregnancy, 44 Ovario-abdominal pregnancy, 44 Ovum, external migration of, 51 — ' — causing extra-uterine pregnancy, 27
— implantation of, in tubes, results of,
56 always accompanied by excessive
amount of hemorrhage, 54
centrifugal, 54
columnar, 53
intercolumnar, 54
mode of, 52
— mechanical arrest of, causing extra uterine pregnancy, 29, 30
— monstrous or deformed, causing ex tra-uterine pregnancy, 29
— normal uterine implantation of, fol lowed by rupture of uterus and abdominal pregnancy, 83
— place of meeting of spermatozoon
and, 53
— resorption of, as termination of
ovarian pregnancy, 34
Pain, of interstitial pregnancy, in contradistinction to that of tubal, 143
— in pelvis, most important and con stant sign of ectopic pregnancy, 126
Palpation in diagnosis of extra-uterine pregnancy, 121
Pelvic mass, in extra-uterine pregnancy, 131
Peritubal adhesions, causing extra-uterine pregnancy, 23
Pigmentation, increased, in ectopic pregnancy, 125
Placentation, in ovarian pregnancy, 75
— in tubal pregnancy, 55 Pseudo decidua, 76
Renal colic, differentiated from ectopic pregnancy, 155
Retroversion of the uterus, normally pregnant, differentiated from ectopic gestation, 153
Ruptured ectopic pregnancy, diagnosis of, 136
— due to bimanual examinations with out sufficient care, 132
— electricity in treatment of, 15
— first American operation for, 15
— gastrotomy in treatment of, 14
— hemorrhage from ovary or tube
simulating, 113
— hemorrhage from rupture of an ap parently normal graafian follicle,
113
— Parry's work on, 12
— treatment of, 162
— ' — immediate laparotomy the rule today, 16 Ruptured interstitial pregnancy, 143 Ruptured ovarian pregnancy, JJ
— followed by ovario-abdominal preg nancy, 44
Salpingitis, acute, differentiated from
ectopic gestation, 151 — causing extra-uterine pregnancy, 24 Shock, postoperative treatment of, 171 Spermatozoon, place of meeting of
ovum and, 53 Sterility, history of, in ectopic pregnancy, 127
Temperature in extra-uterine pregnancy, 133
Tissue changes resulting from extrauterine pregnancy, chorioepithelioma, 84
— decidua formation, 85
Toxemias of pregnancy, complicating
extra-uterine pregnancy, no Triplet tubal pregnancy, 106 Trophoblast, action of, 54
— cells of, 55
Tubal abortion, amount of hemorrhage in, as compared with tubal rupture,
39
— complete, 61
— due to rupture, 57
— followed by secondary abdominal
pregnancy, 42
— incomplete, 62
— relative frequency of tubal rupture
and, 37 Tubal abortion, similarity of, to rupture of tube, 37
— as termination of ovarian preg nancy, 35
— 'treatment of, 162
Tubal hemorrhage, causes and occurrence of, 114
— diagnosis of cause of, 115
— simulating ruptured ectopic preg nancy, 113 Tubal lumen, anomalies of, 25
— obstruction of, from within, 24 from without, 23
Tubal mole, due to rupture, 58
— resulting from death of embryo, 35
— symptomatology and diagnosis of,
141 Tubal polyps, causing extra-uterine
pregnancy, 28 Tubal pregnancy, case of Mauriceau
(1669), 7
— case of Riolan (1604), 6
— -causes of, external migration of
ovum, 51 ^mechanical or postinflammatory
obstruction to ova, 50
Pierre Dionis on (1718), 9
'Regnus Graaf and others, 8
— comparative results with normal and
with pathological embryos, 88
— complicated, 109
by fibroid tumors of uterus, 109
Tubal pregnancy, decidua in, formation of, 54
— decidual reaction causing, 50
— first reported case of (1604), 6
— history of treatment of, 12
— mode of implantation of ovum in
tubes, 52
— pain of interstitial in contradistinc tion to that of, 143
— placentation in, 55
— process of, in advanced cases, 59
— question of removal of non-pregnant
tube as routine procedure in operation for, 102
— 'terminations of, in advanced cases, 60
considerations affecting, 60
by death of embryo with the formation of tubal mole, 35
growth and development of fetus
to full term, while still confined within the tube, 41
hematocele, jy
— ■ — by resorption of the ovum, 34
rupture, 57
— ■ between the folds of the broad
ligament, 39
followed by abortion, 57
followed by tubal mole, 58
into the peritoneal cavity, 37
secondary, intraligamentary pregnancy, 44
— secondary abdominal pregnancy, 43
tubo-abdominal pregnancy, 42
tubo-ovarian pregnancy, 43
by tubal abortion, 35
— tissue changes resulting from,
chorioepithelioma, 84
— triplet, 106
— twin, 104
diagnosis of, 105
— ' — unilateral, characteristic case of,
105
Tubal rupture, amount of hemorrhage in, as compared with tubal abortion, 39
— 'between the folds of the broad ligament, 39
— causes of, coitus, 41
plugging of large intervillous
veins, 59 spontaneous, 40
Tubal rupture, causes of, trauma, 40 vaginal examinations, 40
— extratubal, 58
— followed by intraligamentary preg nancy, 44
— followed by secondary abdominal
pregnancy, 42
— resulting in tubal mole, 58
— ■ followed by tubo-abdominal pregnancy, 42
— mechanism of, 57, 58 acute, 58
described by Miki Kiutsi, 58
— more frequently due to normal than
to pathological embryo, 88
— into the peritoneal cavity, 37
— ■ relative frequency of tubal abortion and, 37
— resulting in tubal abortion, 57
— secondary, 38
— similarity of tubal abortion to, 36 Tubes, fallopian, See Fallopian Tubes Tubo-abdominal pregnancy, following
tubal rupture, 42 Tubo-ovarian pregnancy, 43 Tumors, pressure from, resulting in
extra-uterine pregnancy, 24
— of the tube, causing extra-uterine
pregnancy, 2.y
— uterine, fibroid, complicating tubal
pregnancy, 109 Twin ectopic pregnancy, 104
— diagnosis of, 105
— unilateral, characteristic case of, 105
Urination, increased frequency of, in ectopic pregnancy, 126
Uterine abortion, differentiated from ectopic gestation, 148
Uterine adenomyoma, ectopic pregnancy occurring in gland spaces of, 112
Uterine bleeding, due to extra-uterine pregnancy, 62
Uterine decidua, negative findings not indicative of absence of, 64
Uterine decidua, primary factor in formation of, 87
— relation of decidual casts and, to extra-uterine pregnancy, 64
Uterine involution, due to tubal pregnancy, 62, 63
Uterine involution, due to tubal pregnancy, regressive and reparative stages of, 63
Uterine tumors, complicating tubal pregnancy, 109
Uterus, changes produced in, by extrauterine pregnancy, formation of decidua vera, 62
increase in size, 62
involution, 62, 63
Uterus, changes produced in, by extrauterine pregnancy, uterine bleeding, 62
— enlargement of, in ectopic preg nancy, 125, 132
— increased anteflexion of, in ectopic
pregnancy, 126, 132
— normally pregnant, retroversion of,
differentiated from extra-uterine pregnancy, 153