Endoscopic understanding of ectopic pregnancy

Between the Department of tubal-uterine horn into the muscle wall of the cavity around the thick muscle, to maintain pregnancy to four months before the breakdown occurred. As rich blood supply here, like the breakdown of uterine rupture, very serious symptoms, often in a short period of time in a lot of abdominal bleeding.

1. Tubal pregnancy and the outcome of the changes tubal lumen small, thin wall and the lack of mucosal tissue, far less muscular uterine muscle wall thickness and tenacity that pregnancy can not be formed when the decidua intact, the embryo can not adapt to the growth and development Therefore, when tubal pregnancy developed to a certain period, will take place the following conclusion:

(1) tubal pregnancy abortion: more common in ampulla tubal pregnancy, the incidence of pregnancy in more than 8-12 weeks. Fertilized egg in the fallopian tube planted in the mucous membrane folds, as tubal pregnancy when a wall decidual incomplete development of the blastocyst to the lumen often prominent, and finally coated breakthrough bleeding, with the blastocyst separation wall, if the entire capsule Embryo stripping the fallopian tube into the cavity and reverse peristalsis-the umbrella from the abdominal cavity to form fallopian tubes complete abortion, bleeding generally small. If the blastocyst stripping incomplete, the product of some pregnancy from the abdominal cavity, some still attached to the fallopian tube wall, a tubal incomplete abortion, tubal trophoblast cells continue to erode the wall, leading to repeated hemorrhage, a hematoma or tubal hematoma around the fallopian tubes. Tubal thin because of muscle wall, the contraction of the poor and difficult to stop bleeding, the outflow of blood, accumulate in the uterus lacunae rectal pelvic hematoma formation, in a long time and even into the abdominal cavity.

(2) ruptured tubal pregnancy: more common in isthmus tubal pregnancy, the incidence of pregnancy and more in about six weeks. Fertilized egg in the fallopian tube implantation mucosal folds, when the growth and development at the blastocyst villus direction to the erosion of muscle wall and serosa, the last perforation serosa, a ruptured tubal pregnancy. Tubal rich vascular muscle, caused by a ruptured tubal pregnancy bleeding than tubal pregnancy abortion intense, short-term massive abdominal bleeding can occur so that patients in a shock, also repeated bleeding, pelvic, and the formation of intra-abdominal hematoma. Tubal interstitial pregnancy Although rare, but serious consequences, the outcome of almost all of tubal pregnancy ruptured.

Between the Department of tubal-uterine horn into the muscle wall of the cavity around the thick muscle, to maintain pregnancy to four months before the breakdown occurred. As rich blood supply here, like the breakdown of uterine rupture, very serious symptoms, often in a short period of time in a lot of abdominal bleeding. Ruptured tubal pregnancy or abortion, sometimes to stop internal bleeding in a stable condition, long time, embryonic death or absorption. However, the long-term repeatedly formed by the pelvic internal bleeding hematoma not dissipated, hematoma of the plane and surrounding tissue hardens and adhesion, known as the old clinical ectopic pregnancy.

(3) secondary abdominal pregnancy: whether abortion or ruptured tubal pregnancy, generally from the blastocyst from the oviduct to intra-abdominal or broad ligament, the majority of deaths, not growth, but occasionally there are survivors, if the embryos survive the villi Organization is still in situ or exclusivity attached to the abdominal cavity after the re-cultivation and access to nutrition, growth and development continue to be a secondary abdominal pregnancy. If the broad ligament rupture in the mouth, can be developed for the broad ligament pregnancy.

2. Tubal pregnancy in the uterus and normal pregnancy, the trophoblast cells of the HCG Huang growth, the increase in steroid hormone secretion. Therefore, the cessation of menstruation Lai Chao, the uterus increases softened, endometrial there decidual reaction. If the embryos died, disappeared trophoblast cell activity, since the Palace decidual peeling wall in case of vaginal bleeding. Sometimes decidua can complete dissection, with vaginal bleeding from the triangle of decidua; sometimes showed debris from. Organizations can not see from the villi, histological examination without trophoblast cells. Endometrial changes in the morphology was diversity, with the exception of a decidual endometrial changes, if the embryo has died a long time, endometrial hyperplasia may be a period of change, and sometimes that Arias-Stella (AS) reaction, examination see endometrial glands Of epithelial cell proliferation, increased endometrial gland cells, cell borders unclear, gland cells arranged in Mission, sudden people gland cavity, the disappearance of polar cell nuclei mast, with deep, with the cytoplasm cavity. This endometrial hyperplasia and secretion of the response to steroid hormones may stimulate caused by excessive, although the diagnosis of a certain value, tubal pregnancy, but not unique. In addition, after the death of embryos, some of the villi in-depth muscle still alive, slow degradation of Huang, was still endometrial secretion response.