~"“S41TOm previous poge) *¢ to the internal o: 80 that later in conta bridges the open ‘Causes severe, eve, second part of py ccasionally, the uterus, resul nancy, or ecto les may occur 5 (opening) (Fig. 48) levelopment, the pla- ‘pening (placenta previa) and n life-threatening bleeding in the egnancy and during delivery, implantation takes place outside ting in an extrauterine preg- ic pregnancy. Ectopic pregnan- at any place in the abdominal cavity, Intestinal loo, intemal os of uterus ovary. or uterine tube (Fig. 48). Ninety-five percent | ‘ ine tube, | of ectopic pregnancies occur in the uteri however and moro these rein she ampulla 0% Fig). Inthe abdominal cavity.the Blastoyst most frequently attaches itself tothe peritoneal ining the rectouterine cavity, or pouch of Douglas (Fg 4.10).The blastocyst may also atach itself co the peritoneal covering of the intestinal tract oF the omentum. Sometimes, the blastocyst develops Mesentery Uterine tube Ampulla Fimbriae oral implrtaon ss fhe Bars, inparaon nehesboml cy (AK evn ms feuancy mp reer Data ay pt hy pe Sed See icone querer FN aiputey Cen cl he uan iphone ores et ee Drees (aati etki the arrow porter ot Gauche ubshs ramaion Gam ege eoc eee tela (oor daca prs (278) an & nan pansion in the ovary proper causing a primary gratin Ye ragroes cur h 2X oa Fe eee recount for 9% of al pregency Pre deaths for the mother.In most ectopic preg- relate, che embryo dies about the second month reas Drgeseation and may result in severe hemorshaging in the mother. ‘Abnormal blastocysts are common. For exam implanted blastocysts varyin of 26 implante ysts varying 2 ers oo IT days recovered from patients for ality, 9 346%) were abnormal, Some tf syncytium only: others showed yary- consisted of crophoblastic hypoplasia, In two, the ing desrees vas absent.and in some, the germ disc emory Oe pnormal orientation. Shoe a endhat most abnormal blastocysts would Icis “a vy euced any sign of pregnancy because have Pro} in age of normal fertil not their trophoblast was so inferior that the corpus luceum could not have persisted. These embryos Probably would have been aborted with the next menstrual flow and, therefore, pregnancy would not have been detected. In some cases, however, the trophoblast develops and forms placental mem. branes, although little or no embryonic tissue is present. SucH a condition is known as a hydati form mole. Moles secrete high levels of hCG and ‘may produce benign or malignant (invasive mole, choriocarcinoma) tumors. Genetic analysis of hydatidiform moles indicates that although male and female pronuclei may be genetically equivalent, they may be different fune- tonally. This evidence is derived from the fact that although cells of moles are diploid, their entire genome is paternal. Thus, most moles arise from (continued on folowing page)