[Histologic study of 100 pregnant fallopian tubes]

The 100 fallopian tubes had been obtained from women whose mean age was 30 and whose mean period of amenorrhea was 38 days. Each fallopian tube gave rise to at least sixteen samples and was sectioned if necessary several times. There had been tubal rupture in 25 cases, and in at least 7 cases the rupture involved the ovum and its implantation site. The location of the implantation site could be determined in only 30 cases: 10 in the mesosalpin; x 10 in the antimesosalpinx; 8 lateral and 2 circumferential. The anatomic site of the implantation was isthmic in 7 cases; ampullary in 85 cases, of which 6 were near to the isthmus; infundibular in 7 cases and fimbrial in 1 case. Tubal lesions were found in 22% of the cases, but associated were also found frequently: tubal adenomyosis (17 cases); adherent tubal fimbriae (14 cases); peritoneal adhesions (11 cases) and decidual changes in 12 cases. The 74 remaining fallopian tubes were considered to have been previously normal and to have been affected only by changes linked to the pregnant state (edema, congestion, lymphocytic infiltration) or to complications or this state (a smoothing out of the tubal mucosa; a peritoneal granuloma surrounding blood products; a localized infarct of the fimbriae or wall; and haemorrhage involved in thromboses, ovum detachment or necrosis). The ovum and implantation appeared to be normal in 26 cases and to have had development prematurely stopped because of extensive haemorrhage in 41 cases. In 22 cases there was hypoplasia, and difficulty in determining the cause in 11 cases. From a morphological point of view preserving at least one third of gravid fallopian tubes is justifiable, because the chronic lesions are often discrete and the changes of pregnancy generally appear to be reversible. The persisting pathogenic factors are not necessarily tubal, as can be seen by the role of delays in transport of the ova.