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21 Fallopian tube: Ruptured ectopic pregnancy

Ectopic pregnancy
Age/sex: unknown
Size: 17.1 x 23.4 x 9.2 cm
The uterus has been opened to show a somewhat thickened endometrium (E). Both ovaries (O) appear normal. A fetus with clearly visible legs and right arm is seen next to one ovary. An umbilical cord (arrow) extends from it into an enlarged Fallopian tube, which has ruptured.


Ectopic pregnancy

Implantation and development of a fertilized egg outside the uterus is known as ectopic pregnancy. It is estimated to occur in about 1-2 percent of pregnancies, the risk being greater in older women. The Fallopian tube is the most common site of implantation. Normally, an egg released from the ovary is transported to the endometrial cavity via the Fallopian tube by cilia on the epithelial surface of its inner lining. Ectopic implantation may be the result of impaired ciliary function or of physical alteration in the tube as a result of scarring from endometriosis or previous infection (pelvic inflammatory disease).

Symptoms usually develop between the 4th and 12th weeks of pregnancy and include vaginal bleeding and abdominal pain. If untreated, the enlarged tube can rupture and lead to hemorrhage from the numerous blood vessels that nourish the fetus. In fact, shock following such rupture is the leading cause of maternal death in the first trimester.

The condition was first documented by the Arabic physician Abulcasis (936 – 1013). Until the latter part of the 19th century, it almost always led to maternal death. Following the report of successful treatment by salpingectomy ―surgical removal of the Fallopian tube and fetus—by the Scottish physician Robert Tait in 1884, the survival rate improved considerably. With current diagnostic, surgical and medical techniques, the mortality rate is about 0.1 -2 %.

Below: Implantation in a normal pregnancy vs. possible sites of implantation in ectopic pregnancies.

Source: BruceBlaus. (2015). Ectopic pregnancy. Wikimedia Commons.

Implantation in a normal pregnancy vs. possible sites of implantation in ectopic pregnancies.

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