EXTRA-UTERINE PEEGNANCY 141 



the peritoneum, in the ovary and the oviduct. "We therefore 

 recognize graviditas abdominalis, graviditas ovarialis and gravi- 

 ditas tubaria, or salpingocyesis. 



Graviditas abdominalis (abdominal foetation) is the most 

 common form of extra-uterine pregnancies. Here the impreg- 

 nated ovum is not carried away by the tube, but falls into the 

 abdominal cavity. In a previous chapter it was mentioned 

 that impregnation of the ovum may occasionally take place in 

 the ovaries, provided the Graafian vesicle is ruptured. When 

 this ovum is not caught by the fimbriated portion of tlie Fallopian 

 duct, the impregnated egg may develop in the abdominal 

 cavity, giving rise to a primary ventral foetation. The annexes 

 are formed by the egg, and only the placenta uiaterna is to be 

 replaced. It is a fact that a regular placenta replacing the 

 placenta materna develops on that part of the peritoneum 

 where the impregnated ovum is located. At that spot vessels 

 are formed, cell proliferation and thickening of the serosa take 

 place, resulting in the formation of the placenta, mentioned 

 above (Franck). The foetus may mature here, as it is nourished 

 from the walls of that neo-formation. In extra-uterine primary 

 pregnancy the uterus does not participate any whatever in the 

 development of the foetus (Bovy). 



Course. — When the period of gestation is at an end, the 

 same changes, only less intense, seen during normal parturition 

 take place. The pains are weak, and the cervix uteri is 

 dilated but little. Since the uterus does not deviate any from 

 a normal state, the contractions of the museularis are neces- 

 sarily weak. The abdominal muscles may assist, and thus pains 

 simulating labor pains occur. After this condition has per- 

 sisted for several days, pains cease, the foetus dies, and when 

 th^ air is excluded those changes known as mummification sei 

 in. The foetus becomes a Uthopcedion, possibly remaining for a 

 long time without producing any deviations from normal health. 

 Very rarely, maceration of the foetus may follow (Hartle). St. 

 Cyr and Violet report a case by Coquet where maceration of 

 the foetus was observed. After adhesive inflammation opposite 

 the vulva set in, abscess formation and perforation in the 



