抄録
Ectopic pregnancy is not an uncommon ailment, but at times its abnormal development leads the condition into erroneous diagnosis, resulting in the delay of the proper treatment. The diagnosis of the case is not difficult if the condition of genital bleeding develops after a certain period of amenorrhea, or if there are typical symptoms such as stomach ache or shock symptoms. However, the rupture of ectopic pregnancy is one of the fatal ailments which results in acute intra-abdominal hemorrhage, and therefore its early diagnosis is most important.
The medical examiners of Metropolitan Tokyo conducted administrative necropsies of 6 2 cases of sudden deaths due to the rupture of the ectopic pregnancy which had occurred in the past 16 years (1949-64) in Tokyo proper (23 wards) .
A statistical study of these 62 cases has been compiled, taking into consideration of age, time until death, rupture section, period of pregnancy and rupture section, amount of intra-abdominal bleeding, marital or single status, occupation, and erroneous diagnosis, as follows :
1) Of the cases, 53.2 % were between the ages of 20-29.
2) Thirty-seven per cent died within 12 hours after subjective symptom of the rupture ; further, 90.8 % died within 24 hours.
3) Rupture had occurred in the isthmic part of tubal pregnancy in the ampulla, and in the interstitial part and infundibulum, 51.6 %, 29.0 % and 9.7 %, respectively.
4) The majority, 66.1 %, had bleeding due to intra-abdominal hemorrhage to the amount of 1500-2000 cc. The minimum amount of bleeding was 530 cc, the maximum 4000 cc.
5) Thirty-nine per cent of the women were unmarried.
6) As to the occupation of these women, 9 (14.5 %) were business women while 30 (46.8 %) were housewives.
7) Erroneous diagnosis was observed in 26 cases of 40 women who had consulted doctors. Of these, 6 cases were diagnosed as normal pregnancy and died from bleeding due to abortion.
8) When a matured female visits a doctor and complains of stomach pain, first of all one must think of rupture of the ectopic pregnancy. Even though she is not married, be wary. If she is not married, she may hesitate to disclose the fact that her menstration has stopped and may not want to admit pregnancy.
