The relationship between injured uterosacral ligaments and ectopic pregnancy
WAN Li1, Cai Yaoyao2, CHEN Haiyan3, EMMANUEL Ansong2, WU Xueqing2.
1.Department of Pathology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015; 2.Department of Gynaecology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015; 3.Department of Gynaecology, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325027
WAN Li,Cai Yaoyao,CHEN Haiyan, et al. The relationship between injured uterosacral ligaments and ectopic pregnancy[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(9): 656-659.
Abstract：Objective: To compare the morphology of uterosacral ligaments and the distribution of nerve fibers in the isthmus of the fallopian tube in patients who presented with ectopic pregnancy with previous history of induced abortion and patients who presented with ectopic pregnancy with out history of prior surgical procedures. The relationship between abortion and ectopic pregnancy were also explore and investigated to offer new research ideas into the pathogenesis and management of tubal pregnancy. Methods: The patients with ectopic pregnancy were subdivided into two main groups per their history of induced abortion. The induced abortion group comprised of 20 cases with reproductive history of 0-0-N-0 and the no-abortion group comprised of 12 cases with reproductive history of 0-0-0-0. The isthmuses of the fallopian tube from these two groups were obtained and were immunohistochemically analyzed to detect the protein gene product 9.5 in comparison with results from the morphology of the uterosacral ligaments. Results: ①The uterosacral ligaments were symmetrical and smooth with complete arches connecting the right and left ligaments (10/12, P<0.05) in the no-abortion group. In the nulliparous women with prior surgical evacuations, there was evidence of injury to one, or both, uterosacral ligaments (19/20, P<0.05), and possible neovascularisation of peritoneal surfaces over the ligament and adjacent peritoneum and mesosalpinx. ②The strong positive expression of PGP 9.5 in the nerve fiber from the inner and outer muscle layer of the isthmus of fallopian tube in abortion group was significantly reduced when compared with the no-abortion group (P<0.05). ③PGP 9.5 showed a strong positive expression in the mesosalpinx of the fallopian tube among the two groups (P>0.05). Conclusion: Induced abortion may damage the nerves in the uterosacral liagments and the endometrial-muscular interface and the decrease of PGP 9.5 positive nerve fibers expression in the muscle layer of the isthmus of fallopian tube may lead to the occurrence of ectopic pregnancy.
