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Ectopic pregnancy

Etiology: • Associated with previous tubal damage from • endometriosis • surgery • pelvic inflammatory disease

Pathogenesis: • damage to fallopian tube which may be mechanical or functional

Epidemiology: • Reproductive age women • History of sexually transmitted disease • History of endometriosis

General Gross Description: • dilated, congested fallopian tube with or without rupture site • lumen filled with soft, tan hemorrhagic villi and occasionally with recognizable amnionic sac with embryo • lumen also containing blood clot

General Microscopic Description: • lumen contains chorionic villi of first trimester type with complete layer of cytotrophoblast and syncytiotrophoblast surrounding stroma containing vessels with nucleated erythrocytes • implantation site in tubal wall with converting decidual vessels

Clinical Correlations: • patients may have typical signs of pregnancy until approximately 8 weeks of gestation • develop acute abdomen with shock from hemorrhage into the peritoneal cavity • surgical emergency • can remove entire tube or simply contents with repair

References: • Cotran RS, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease. 5th edition. W.B. Saunders Philadelphia 1994. pp. 1079