OVARIAN AND ABDOMINAL PREGNANCY. 



655 



no gestation can begin its development, except in some part of 

 the genital tract derived from the Miillerian ducts which form the 

 uterus and tubes." This, of course, rules out both abdominal and 

 ovarian pregnancy. Of the latter, Webster says : " Supposed 

 cases of ovarian pregnancy require to be studied carefully, and in 

 every instance must be distinguished from the following condi- 

 tions, which may be mistaken for it, viz., pregnancy in the outer 



FIG. 439. Prof. August Martin's case of ovarian pregnancy. The intact tube is 

 seen lying above the ovarian sac containing the fetal envelopes. 



end of the tube which has become intimately connected with the 

 ovary ; pregnancy in an accessory tube-end which has become 

 attached to it ; pregnancy in the ovarian fimbria, which may be 

 hollow sometimes, representing the extreme outer end of the tube ; 

 pregnancy in the tube which has extended into the ovarian sac 

 of peritoneum, which occasionally occurs in women." 



The terms " extra-uterine pregnancy " and " ectopic pregnancy " 

 are ordinarily used synonymously, but there is really a distinction. 



The term "ectopic" implies that the gestation is outside the 

 uterine cavity. A gestation may occur in that part of the Fallo- 

 pian tube which is situated in the uterine wall. Such an one, 

 described under the name " interstitial" would not be " extra- 

 uterine," for it is within the uterus. It would, however, be " ec- 

 topic." If the view of Webster is correct, all ectopic gestations 

 must be of tubal origin. He divides them into five subdivisions : 

 1. Ampullar, in which the gestation begins in the ampulla or mid- 

 dle portion of the tube, and he regards this as by far the most 

 common. 2. Interstitial, in which the gestation develops in that 



