Obstetric and Gynecological Nursing - The Carter Center

the rupture is on the mesenteric side of the tube, a broad
ligament haematoma will form.
D. Secondary abdominal pregnancy
Very rarely the extruded ovum continious to grow as sufficient
trophoblast maintains its conception with the tubal epithelium
and latter the trophoblast covering the ova sac attaches to
abdominal organs. A few of these pregnancies advance to
term and in a few fetus dies early.
Two clinical patterns occur, and are due to the extent of the
damage to the tube wall by the invading trophoblast. The first
is sub acute, the second acute.
Sub acute
After a short period of amenorrhea, the patient complains of:
- some lower abdominal discomfort, may be so mild
- occasionally there is an attack of sharp pain and
faintness,
- an attack of sharp pain favored by slight breeding
- Tenderness of a lower abdomen on examination
- Vaginal examination show a tender fornix or a vague
mass
- If the patient is observed, further episodes of pain will
occur
- Vaginal bleeding, usually brown in color causing acute
collapse indicating tubal rupture or incomplete tubal
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