When the ectopic ovum begins to develop in the Fallopian tube the placental villi erode the tubal wall and the blood-vessels. At length the ovum slips out of the ampulla--the common result--or the tube bursts. The break may be traumatic in origin, from jarring or a like accident, or it may be spontaneous. If the rupture is through the tube there is hemorrhage into the pelvic cavity; if the ovum slips out of the ampulla the tubal abortion causes hemorrhage as in uterine abortion. In either case the blood with peritoneal fibrin forms a hematocele, and this, with the ovum, may be finally absorbed; or the woman may bleed to death unless the hemorrhage is checked surgically; or the child may live for varying periods up to term. The tube rarely ruptures into the fold of the broad ligament. The fetus usually dies after rupture or tubal abortion, and if it has not advanced beyond the eighth week it is absorbed. Sometimes it lives. When the rupture or abortion does not tear the placental site the fetus may develop in the abdominal cavity. Between 1889 and 1896 Haines[103] found 40 operations for ectopic gestation done after the seventh month of pregnancy with 10 maternal deaths. Of the children, 27 survived the operation from a few moments to fifteen years. Sittner, in 1903, compiled from the medical reports 142 cases of viable ectopic fetuses, and Essen found 25 additional cases. Since Essen's article more have been reported, about 173 to my knowledge, but the number is considerably larger. [103] Kelly's _Operative Gynaecology_. New York, 1898. Hirst says an experienced obstetrical specialist sees from 12 to 24 cases of ectopic pregnancy annually. Küstner himself operated on 105 cases in five years. About 78 per cent. of all ectopic gestations result in tubal abortion and 22 per cent. in rupture.