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Gynaecology & Obstetrics General 870c19c0

A patient in shock diagnosed of having ectopic pregnancy in right fallopian tube. The cause of fetal death in ectopic pregnancy is postulated as:

A
Vascular accident
B
Nutritional adequacy
C
Endocrine insufficiency
D
Immune response of mother
High-Yield Explanation
Lack of a submucosal layer within the fallopian tube provides easy access for the feilized ovum to burrow through the epithelium and allow implantation within the muscular wall. As the rapidly proliferating trophoblasts erode the subjacent muscularis layer, maternal blood pours into the spaces within the trophoblastic or the adjacent tissue. The fallopian tube cannot sustain the growing pregnancy. This causes rupture and bleeding which expels the implantation out of the tubal end as tubal aboion. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 7. Ectopic Pregnancy. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e.

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