Summary
The tissue from three tubal pregnancies at the site of implantation has been investigated with light and electron microscopy. Large seemingly “decidual” cells were found to be present between the anchoring villi and the tissue of the uterine tubes. These cells are or cytotrophoblastic column origin. Through discontinuities of the syncytiotrophoblast they migrate into the underlying tissue were they grow and synthesize large amounts of glycogen. It is suggested that these cells be named pseudodecidual cells in order to distinguish them clearly from genuine decidual cells to which they only bear a resemblance on the light microscopical level. The fibrinoid present at the utero-placental interface in eutopic implantation cannot be found in ectopic implantation. From this fact it is deduced that fibrinoid is formed through the action of genuine decidual cells and therefore must be of maternal origin.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Blandau RJ (1961) Biology of eggs and implantation. In: Young WC (ed) Sex and internal Secretions, 3rd edn., vol. 2. Williams & Wilkins, Baltimore, pp 797–882
Dallenbach-Hellweg G (1975) Histopathology of the endometrium. Springer, Berlin
De Feo VJ (1963) Determination of the sensitive period for the induction of deciduomata in the rat by different inducing procedures. Endocrinology 73: 488–497
Dougherty CM, Anderson MR (1964) Endometriosis and andenomyosis. Am J Obstet Gynecol 89: 23–40
Finn CA, Keen PM (1962) Studies on deciduomata formation in the rat. J Reprod Fertil 4: 215–216
Gould SF, Shannon JM, Cunha GR (1983) Nuclear estrogen binding sites in human endometriosis. Fertil Steril 39: 520–524
Herr JC, Heidger PM Jr, Scott JR, Anderson JW, Curet LB, Mossman HW (1978) Decidual cells in the human ovary at term: I. Incidence, gross anatomy and ultrastructural features of merocrine secretion. Am J Anat 152: 7–28
Herr JC, Fares NH, Banhawy MA (1987) Decidual cells in the human ovary at term: II Morphometric analysis of cytoplasmic processes and organelles. Am J Anat 179: 277–284
Kindermann G (1988) Endometriose. Wesen und Entstehung In: Friedberg V, Thomsen K (eds) Gynaekologie und Geburtshilfe. (Spezielle Gynaekologie 2, vol. III/2). Thieme, Stuttgart, pp 13.0–13.11
Kuzela DC, Speers WD (1985) Heterotopic endometrium of the fallopian tube. Fertil Steril 44: 552–553
Lawn AM, Wilson EW, Finn CA (1971) The ultrastructure of the human decidual and predecidual cells. J Reprod Fertil 26: 85–90.
Loeb L (1908) The production of deciduomata and the relation between the ovaries and the formation of the decidua. JAMA 50: 1897–1901
Ludwig KS, Spornitz UM (1977) Veränderungen des Endometriums beim Progestasert-System. Acta Anat 99: 237
Mall-Haefeli M, Ludwig KS, Spornitz UM, Uettwiller A (1976) Die Low-Dosis-Gestagen-Therapie Geburtshilfe Frauenheilkd 36: 645–660
Miller MM, O'Morchoe ChCC (1982) Decidual cell reaction induced by prostaglandin F2 alpha in the mature oophorectomized rat. Cell Tissue Res 225: 189–199
Pauerstein CJ, Coxatto HB, Eddy CA, Ramzy I, Walters MD (1986) Anatomy and pathology of tubal pregnancy. Obstetrics and Gynecology 67: 301–308
Pijnenborg R, Dixon G, Robertson WB, Brosens I (1980) Trophoblastic invasion of human decidua from 8 to 18 weeks of pregnancy. Placenta 1: 3–19
Romeis B (1968) Mikroskopische Technik. R. Oldenbourg, München
Sananes N, Baulieu EE, Le Goascogne C (1981) A role for prostaglandins in decidualization of the rat uterus. J Endocr 89: 25–33
Schmidt CL (1985) Endometriosis: A reappraisal of pathogenesis and treatment. Fertil Steril 44: 157–173
Schweppe KW, Wynn RM (1984) Endocrine dependency of endometriosis: an ultrastructural study. Europ J Obstet Gynec Reprod Biol 17: 193–208
Schweppe KW, Wynn RM, Beller FK (1984) Ultrastructural comparison of endometriotic implants and eutopic endometrium. Am J Obstet Gynecol 148: 1024–1039
Shelesnyak M (1957) Aspects of reproduction. Some experimental studies on the mechanism of ovaimplantation in the rat. Rec Prog Horm Res 13: 269–322
Spornitz UM (1992) The functional morphology of the human endometrium and decidua. Adv Anat Embryol Cell Biol 124: 1–99
Spornitz UM, Ludwig KS, Mall-Haefeli M (1984) Ultrastructure of the decidual response to a progesterone-releasing IUD. In: Hasson H, Hafez ESE, van Os WA (eds) Biomedical Aspects of IUDS. Advances in Reproductive Health Care, vol. 5. MTP Press LTD, Lancaster, pp 3–23
Vierikko P, Kauppila A, Roennberg L, Vihko R (1985) Steroidal regulation of endometriosis tissue: lack of induction of 17beta-hydroxysteroid dehydrogenase activity by progesterone, medroxyprogesterone acetate, or danazol. Fertil Steril 43: 218–224
Weller CV (1935) The ectopic decidual reaction and its significance in endometriosis. Am J Pathol 11: 287–291
Wewer UM, Faber M, Liotta LA, Albrechtsen R (1985) Immunochemical and ultrastructural assessment of the nature of the pericellular basement membrane of human decidual cells. Laboratory Investigation 53: 624–633
Wynn RM (1974) Ultrastructural development of the human decidua. Am J Obstet Gynecol 118: 652–670
Author information
Authors and Affiliations
Additional information
Dedicated to: Prof. Dr. K. S. Ludwig on the occasion of his 70th birthday.
Rights and permissions
About this article
Cite this article
Spornitz, U.M. Pseudo-decidualization at the site of implantation in tubal pregnancy. Arch Gynecol Obstet 253, 85–95 (1993). https://doi.org/10.1007/BF02768734
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02768734