98 STUDIES ON PATHOLOGIC OVA. 



fetus seem to be very common in this group of macerated fetuses, and probably 

 can be attributed to the same factors which produce the twisting. This, how- 

 ever, does not imply that the structural changes in these cords are different from 

 those present in other groups or that torsion was the cause of fetal death. It is 

 largely, if not wholly, a matter of degree of difference, and this degree is deter- 

 mined very largely by the age of the fetus, the length of retention, and perhaps 

 by the irritability of the uterus. The greater tortuosity of these, as compared 

 with normal cords, as stated above, can be explained in the same way. 



The decidua was present in 45.3 per cent of the 53 specimens remaining in 

 this group. It was infiltrated in 17, or 70.8 per cent. The infiltration was marked 

 in 29.1 and slight in 70.9 per cent. Although decidual infiltration was present in 

 88.9 per cent of all cases in group 6 in which the decidua was included, this was 

 the case in only 70.8 per cent of the cases in group 7. The percentage in this 

 group is lower than in any other save group 5, suggesting that the infiltration is 

 not entirely dependent upon the length of retention in utero after fetal death. 



Hydatiform degeneration could be recognized in only 10.9 per cent of the 

 cases. The decidua was infiltrated in the 2 cases in which it was present, but 

 since the number of cases concerned is so small, no special importance can be 

 attached to this fact did it not accord with the findings in the other groups. All 

 chorionic vesicles in which this change was noted were in relatively early stages of 

 development. 



In trying to correlate the clinical histories of the uterine specimens with the 

 objective examination, nothing especially interesting was revealed. The corre- 

 spondence between the two is no better in this than in the other groups. In 

 general it may be said, however, that the specimens of this group have been 

 retained longer after death, and that this fact is supported by the great frequency of 

 the presence of calcification and coagulation necroses, or so-called "infarct" for- 

 mation, which was relatively common in the placenta. The greater maceration 

 of the specimens clearly is evident from inspection alone. Subchorial hemato- 

 mata were present in several specimens, and chorionic cysts were noticed in one. 

 Changes reported by Welch (1888) as hyaline metamorphosis of the placenta were 

 present in a fair percentage, especially in the older and longer retained placentas, 

 and will be considered further in a subsequent chapter. 



The frequency of divergence from the normal form on the part of the fetuses 

 in abortuses also impressed Granville (1834), and Panum (1860) stated that he found 

 the frequency of double malformations among museum collections to be twice that 

 in actual life. Panum found cyclopia in 16 of 618 human deformities, 25 among 143 

 simple deformities in sheep, and 37 in 91 deformed fetuses. He also believed that 

 various deformities of the jaws in certain quadrupeds probably are due to intra- 

 uterine pressure. He came to this conclusion, it seems, because of his experience 

 while incubating eggs. However, according to Panum, spina bifida occurs much 

 more commonly in man than in animals, and he expressed the opinion that the 

 study of comparative teratology may contain the open sesame for a comprehen- 

 sion of many, even if not of all, abnormalities. 



