One. History and Implantation
One. History and Implantation
First, one of the major factors in Maria's condition is her history of PID or Pelvic Inflammatory Disease and salpingitis. PID is an infection of the female upper reproductive organs, including the uterus, fallopian tubes, and nearby tissues. It usually occurs when bacteria from the vagina or cervix travel upward into the reproductive tract, causing infection and inflammation.
Salpingitis is the specific inflammation or infection of the fallopian tubes. When the tubes become infected, the body responds with inflammation and tissue damage. As the body heals from this infection, it forms scar tissue, which is thicker and less flexible than normal tissue. This healing process can also lead to adhesions, which are bands of scar tissue that cause nearby tissues or organs to stick together.
Because of this scarring and adhesions, the fallopian tube can become narrowed, partially blocked, or distorted, making it difficult for the fertilized ovum to pass through normally. Normally, after fertilization, the zygote travels through the fallopian tube toward the uterus, where implantation should occur.
However, in Maria's case, because of the narrowing and obstruction caused by previous PID and salpingitis, the fertilized ovum was unable to reach the uterus. Instead, it became trapped inside the fallopian tube and implanted there, which eventually resulted in an ectopic pregnancy.
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Two. Tubal Rupture and Pain
Two. Tubal Rupture and Pain
As the embryo continued to grow inside the narrow tube, the fallopian tube was not able to stretch enough to accommodate it. Dahil manipis lang ang structure ng tube, eventually nag-rupture ito, which caused Maria's sharp and stabbing pain in the right lower quadrant.
Kasabay nito, ang dugo na nag-leak mula sa ruptured tube ay naipon sa peritoneal cavity. This blood irritated the diaphragm and the phrenic nerve, kaya nakaranas si Maria ng referred pain sa right shoulder. Kahit na nasa abdomen ang source ng problem, ang pain ay nafi-feel sa shoulder dahil sa shared nerve pathways.