FETUS COMPRESSUS. 97 



mortem passive fetal movements. Had this twisting occurred during the life of 

 the fetus and been the cause of its death, one would expect to find some adjustment 

 to it on the part of the growing tissues. Such an adjustment, however, does not 

 exist. The tissues are necessarily displaced mechanically, but no adhesions be- 

 tween adjacent turns were observed save such as easily could be attributed to 

 maceration changes. Since no external forces save those of the uterine contrac- 

 tions can reach a dead fetus, it seems that this twisting, even if not always present, 

 must result from uterine contractions. Since these contractions in many instances 

 may have been more pronounced and prolonged than usual until abortion finally 

 occurred, the greater twisting present in these cords could easily be explained in 

 this way. If we assume that in a given uterus this peristalsis occurs in a uniform 

 direction, and that in a small percentage of uteri it may occur in an opposite 

 direction, torsion in different directions could be accounted for. I realize fully that 

 direct observations upon the living uterus are necessary to make this supposition 

 valid, but in any case it is difficult to conceive of any other agent than uterine 

 contractions that possibly could rotate a dead fetus. It also is evident that this 

 rotation probably would have to occur very largely before marked absorption of 

 the amniotic fluid had occurred and entirely before the fetus became embedded 

 in a mass of coagulum, such as is illustrated by No. 261, a specimen with a very 

 tortuous cord. 



Although it is conceivable that coils of the cord could cause the amputation 

 of an extremity, this probably could occur only in comparatively early stages of 

 development and hardly so late in fetal life as implied in figure 187 of Broman 

 (1911). It is also noteworthy that, although coils of the cord about the extremi- 

 ties were frequently found, not a single instance of partial amputation or of macer- 

 ated amputated extremities is contained among over 2,000 specimens in the 

 Carnegie Collection. 



It does not seem unlikely that the location of the placenta in utero may be 

 instrumental in determining both the amount and the extent of torsion, but until 

 more is known regarding uterine peristalsis all this remains merely a matter of 

 surmise. The tubal and ovarian specimens unfortunately do not throw much 

 light on this question, for they usually are very young and too macerated or dam- 

 aged. Only one of all the tubal specimens, among both normal and pathologic, 

 contained in the Carnegie Collection, had a cord sufficiently long to be of any 

 value in this matter, and in this specimen definite torsion was present. This 

 fact does not prove, however, that peristalsis is not a factor in torsion, for tubal 

 peristalsis could produce similar results. 



Not infrequently the cords show marked bleb formation, as illustrated in 

 Nos. 1475 and 1523 (figs. 54 and 70), but bleb formation, which is present else- 

 where in many of these specimens, is not peculiar to the group, for it is common 

 also in younger cords and fetuses, and may also be localized elsewhere on the 

 body, as in Nos. 1523 and 2261 (figs. 71 and 72). In other instances, as in No. 

 590, the entire cord is decidedly swollen, or alternately swollen and constricted, 

 and in still others it is practically without a turn and wholly without knots, 

 although long and filamentous. Coils of the cord about various portions of the 



