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STUDIES ON PATHOLOGIC OVA. 



years before. November and December periods missed 

 before this abortion, December 26. No venereal diseases. 

 Family very fertile. 



(4) The mole is solid, stratified, and hemorrhagic, 

 measuring 55X25X25 mm. Upon opening, it was found 

 to be composed of a slit-like cavity running into the larger 

 part of the specimen, which upon sectioning proves to be 

 the amniotic cavity. 



(5) Into this there extends the stub of an umbilical cord 

 containing several very large blood vessels, and also a 

 large cavity partially filled by a reticular mass. The cho- 

 rionic wall and villi are very fibrous, and are matted 

 together into a great mass by blood and quite active tropho- 

 blast. On the outside are remnants of decidua which are 

 markedly inflamed. 



(6) Severe infiltration. 



No. 922. 



(1) H. F. Cassidy, Roland Park, Maryland. 



(2) A 60X45X26 mm. 



(3) Negro, age 24 years, married in 1908. Two children, 



5 and 2 years. This is the only abortion. Last menstrual 

 period May 20 to 22 and abortion June 24 following (1914). 

 Four or five days before abortion just a show, then about 

 a normal flow. Lifted a heavy child and felt some pain 

 then. No history of infection. Pregnancies not attended 

 by fever. 



(4) The specimen is a pear-shaped abortion mass meas- 

 uring 60X45X26 mm., and consists chiefly of thick, 

 blood-infiltrated chorionic walls which inclose a smooth- 

 lined cavity 20X9 mm. No trace of an embryo can be 

 seen. 



(5) The specimen is very hemorrhagic, with a very thin 

 chorionic membrane and an amnion which is much folded 

 upon itself. The decidua is ill-preserved, markedly infil- 

 trated and hemorrhagic, and near it lie a very few fibrous 

 villi. The trophoblast is mostly necrotic. The wide space 

 (5 mm.) between the decidua and the chorion is filled with 

 fresh blood. 



(6) Marked infiltration; some hydatiform degeneration. 



No. 960a. 



(1) Marcus Ostro, Baltimore, Maryland. 



(2) A 90X70X25 mm. 



(3) Patient aged 32 years, married in April 1909. Three 

 pregnancies, one abortion. Last menstrual period October 

 3 to 8, 1914; abortion October 16 following. Patient dis- 

 charged from hospital March 29, 1914, after having had a 

 post-partum hemorrhage. Menstruated regularly every 

 month thereafter until abortion, each period lasting 4 to 



6 days. Flow free, no pain. Two days after the last period 

 ceased, bleeding began again and continued up until the 

 time of entrance to the hospital, October 15. The hemor- 

 rhage was very profuse during the two days preceding the 

 abortion, and the patient had become very weak and ane- 

 mic. On October 16 the specimen was passed. Husband 

 has triple-plus Wassermann on blood and spinal fluid. 



(4) The specimen consists of a mass of clotted blood 

 90X70X25 mm., but the greater part is separated easily, 

 leaving a placental mass with torn chorionic sac. No 

 embryo was found. What was apparently the stump of 

 the umbilical cord could be recognized. 



(5) Sections of the chorion show a leucocytic infiltration 

 within its cavity which involves the amnion. The villi are 

 well-developed, largely non-vascular, and have undergone 

 a peculiar degeneration which is neither mucoid nor fibrous; 

 they are matted together with inflamed exudate, mucoid 

 substance, and more or less active trophoblast. There are 

 also numerous plaques of nuclear dust. A layer of fibrinoid 

 substance covers the chorionic membrane as well as the 

 tips of the villi. There are nests of trophoblast cells 

 within the inflammatory mass, probably within the blood- 

 vessels. It would appear as though the embryo escaped 

 some time before the abortion, leaving a normal chorion 

 which underwent degeneration. 



(6) Intense infiltration. 



No. 962o. 



(1) J. M. Jackson, Pittsburgh, Pennsylvania. 



(2) A 35X35X35 mm. 



(4) The specimen is covered with decidua and has a 

 smooth inner surface, to which is attached a delicate cord 

 about 15 mm. long. This ends in a collapsed bag, measur- 

 ing 30X5X8 mm., apparently in the amnion. 



(5) Sections of the chorion show it to be thin and lined 

 with a great deal of reticular magma. The villi on the 

 outside are delicate, the mesenchyme having undergone 

 mucoid degeneration, and there is some mucoid substance 

 between them. The individual villi are well covered with 

 trophoblast, all of which is vascular and very much more 

 extensive than usual. 



(6) Early hydatiform degeneration. 



No. 976. 

 (1) J. C. Bloodgood, Baltimore, Maryland. 



(3) Patient aged 38 years; married. One pregnancy 2 

 years before, ending in miscarriage at second month. 

 Family and past history unimportant. Present trouble 

 began with nausea about 4 months before curettage. 

 At first this was slight and intermittent, but for the last 



2 months it had been continuous and severe. Patient 

 noticed no irregularities or abnormalities about her 

 periods until September, when, although appearing on 

 time, the flow was very scanty and lasted only 3 days 

 instead of a full week as previously. After that she be- 

 came worse, and there was bleeding for 2 weeks before 

 operation. The hemorrhage was slight, and at no time 

 did she pass any clots. During that time the patient was 

 constipated and constantly nauseated, vomiting every- 

 thing she took. At no time did she have any pain except 

 a dull backache. This had been present for 4 months 

 and was worse at her periods. No leucorrhea. 



(4) Specimen consists of about 40 c.c. of uterine curet- 

 tings, a considerable portion of which is chorionic mem- 

 brane. Attached to one piece of this membrane is a 

 cylindrical embryo 5 mm. long. Part of the chorion 

 appears to have normal villi, while sections of another 

 show its main wall to be very fibrous and the villi quite 

 edematous, containing many Hofbauer cells. The entire 

 ovum is encircled by a mass of leucocytes and shows an 

 extensive inflammatory reaction in the uterus. The part 

 of the chorion containing the embryo does not seem to 

 have this inflammatory reaction. 



(5) The piece of the chorion to which the assumed 

 embryonic mass was attached was cut into serial sec- 

 tions, but upon examination it was found not to be such. 

 The overlying trophoblast at this point and the decidua 

 are very markedly inflamed. 



(6) Severe infiltration. 



No. 985. 



(1) A. F. Ries, Baltimore, Maryland. 



(2) A 70X50X35 mm. 



(3) Patient aged 34 years; married about 14 years. 

 Seven previous pregnancies. This abortion November 19, 

 1914. Endometritis, cystocele, rectocele, and lacerated 

 perineum. Family fertile. Specimen was passed in two 

 parts, with 12 hours interval between; first the ovum, 

 then the decidua. 



(4) Ovum 70X50X35 mm., with thick irregular walls. 

 Apparently it is inverted and contains a fibroid nodule. 



3 mm. in length, which, when sectioned, seemed to be 

 the umbilical cord. 



(5) Sections show the chorion with many villi, with 

 degenerate nuclear mesenchyme containing some blood- 

 vessels. There are several enormous Hofbauer cells 

 scattered through the villi; in fact, they might be called 

 giant cells. There is a great deal of blood between the 

 villi, and the trophoblast is fairly active. The overlying 

 decidua is very hemorrhagic and infiltrated. The embry- 

 onic nodule was cut into serial sections and proved to be 

 the umbilical cord, which has undergone fibrous degenera- 



