A patient in shock diagnosed of having ectopic pregnancy in right fallopian tube. The cause of fetal death in ectopic pregnancy is postulated as:
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.
Vascular accident
Nutritional adequacy
Endocrine insufficiency
Immune response of mother