156 



STUDIES ON PATHOLOGIC OVA. 



(4) The vesicular ovum, which is covered with long, 

 ragged villi, is filled with clear fluid. The walls are trans- 

 parent and contain a broken embryo, probably patho- 

 logical, measuring approximately 10 mm. The entire 

 embryo, with its attachment to the chorion, was cut into 

 serial sections. 



(5) The ehorionic membrane is thin and fibrous, and 

 the villi consist of long, delicate fibrous strands with prac- 

 tically no vessels or trophoblast, except occasional small 

 nodules which appear to have undergone degeneration. 

 There are a few remnants of blood-vessels in the villi, 

 showing that at one time they must have had a circula- 

 tion. The umbilical cord also is thin and fibrous, with 

 degenerating vessels and cavity formation. The amnion 

 is partly separated from the non-vascular chorion. The 

 tissues of the embr.vo are somewhat dissociated and slightly 

 macerated. The blood-vessels are well distended with 

 blood, and there is a large extravasation in the peritoneal 

 cavity. Sections which pass through the leg-bud indi- 

 cate that it is slight!} stunted in its growth. 



(0) Decidua absent. 



No. 604. 



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



(2) A 70X50X50 mm.; B 17 mm. 



(4) This vesicular specimen is constricted in the middle 

 and its surface is not uniform, being covered partly with 

 fibrin clots and partly with decidua and some ragged villi. 

 The walls are 3 or 4 mm. in thickness, and the interior is 

 filled with a jelly-like magma of uniform consistency. 

 On one side, lying free within the magma, is an embryo 

 with an atrophic head, arms, and legs. The head is not 

 bent as it should be at this stage, but is erect. 



(5) Sections show a fibrous ehorionic membrane sur- 

 rounded by a few very degenerate villi, much blood, and 

 fibrinous substance. This layer is capped by an inflamed 

 decidua. The trophoblast is thickened, and it, as well 

 as the mesenchyme of the villi, are infiltrated with round 

 cells. The embryo shows considerable maceration, and 

 the dissociation of the tissues is so great that only the 

 cartilages can be made out with certainty. The liver is 

 necrotic, and the walls and cavities of the heart are prac- 

 ticall> obliterated, the whole organ being converted into 

 a mass of round cells. The same is true of the neck, 

 and the entire skull and spinal canal are rilled with the 

 dissociated and macerated brain and spinal cord. In the 

 latter the cells of the floor-plate still hang together, show- 

 ing the characteristic structure of this region as seen in 

 normal embryos. 



(6) Marked infiltration of the decidua. 



No. 635c. 



(1) A. C. Pole, Baltimore, Maryland. 



(2) B 18 mm. 



(5) Sections of the embryo show that all the tissues are 

 macerated. The outline of some of the blood-vessels is 

 not sharp, some of the cells have migrated into the adjacent 

 tissues, and the periphery of the cartilages shows disso- 

 ciation. Hence it is probable that this embryo died some 

 time before the abortion. 



(6) Decidua and chorion absent. 



No. 651a. 



(1) G. L. McCormick, Sparrows Point, Maryland. 



(2) A 70X45X45 mm.; B 27 mm. 



(4) The embryo, which is normal in form, with the pos- 

 sible exception of the lower part of the bodj, came within 

 the amniotic sac, which measures 70X45X45 mm. No 

 chorion is present. The lower part of the spinal canal 

 is opened, the opening being 1 mm. in width and 4 mm. 

 in length. Both legs appear deformed, the left less so 

 than the right, the latter having a marked bend at the 

 knee. 



(5) Sections through the amnion show it to be fibrous 

 and macerated. Where the vessels pass through it there 



is some dissociation. The embryo was cut into serial 

 sections which show that the tissues are greatly macer- 

 ated. The brain and what is left of the spinal cord are 

 practically solid, the latter filling the spinal canal incom- 

 pletely in the thoracic region. The skin forms a groove 

 in the lower lumbar region in which the cord is really 

 absent. The skin is fairly intact, but the tissues are 

 markedly dissociated; that is, the boundaries of the organs 

 and cartilages are obliterated by an irregular wandering 

 of the cells. This is especially marked at the beginning 

 of the umbilical cord. 



(6) Decidua and chorion absent. 



No. 651c. 



(1) G. C. McCormick, Sparrows Point, Maryland. 



(2) B 17 mm. 



(4) A deformed embryo with an atrophic head and 

 injured cord, rounded in form. The arms and legs appear 

 atrophic. 



(5) The tissues are dissociated, macerated and largely 

 necrotic. % The central nervous system is solid. 



(6) Decidua and chorion absent. 



No. 653. 



(1) Ira L. Fetterhoff, Baltimore, Maryland. 



(2) A 80X50X35 mm. B 11 mm. 



(3) Patient is a young woman who has been married 

 about 2 years. First pregnancy. Apparently healthy, 

 and in this case had gone the normal course of a woman 

 4 months pregnant. Physician was called to attend 

 her for bleeding, without pain; an hour later he was re- 

 called to attend her in severe pain, when she passed this 

 specimen. 



(4) The fresh specimen was brought to the laboratory 

 and fixed in 10 per cent formalin. Care was taken not to 

 injure the embryo, and on opening the chorion a rudi- 

 mentary body, uninjured, and markedly deformed, was 

 found. The ovum is covered with a few irregular, ragged 

 villi and scraps of decidua. It contains a large cavity 

 and an embryo 11 mm. long. 



(5) Sections through the chorion show it to be composed 

 of an irregular mass of blood, decidua, fibrinoid substance, 

 degenerated villi, and a curious combination of chorion 

 and amnion, forming in several places processes which 

 extend into the amniotic cavity. There is only a slight 

 amount of inflammatory reaction on the outside of the 

 specimen. A considerable amount of nuclear dust is 

 present. The embryo is markedly dissociated, but the 

 organs can be outlined within it. The cartilages are fairly 

 sharp, but dissociated. The liver is the only organ retain- 

 ing any of its normal structure. The extremities are 

 rounded off and dissociated, but there is no central ner- 

 vous system, and it is impossible to find any canal for it. 

 The vertebrae and ribs can be outlined, and in this region 

 the tissues are not broken. The heart is almost completely 

 dissociated and protrudes through an opening in the 

 thorax. 



No. 675. 



(1) John Woodman, New York City. 



(2) A 50X30X25 mm.; B 10 mm. 



(3) Patient has had several previous miscarriages. 

 Hemorrhage began on February 10 and was profuse. 

 There was another hemorrhage a month later, which 

 became very severe at the time of the abortion, April 14. 



(4) The ovum measures 50X30X25 mm. and is 

 covered with a few atrophic villi. On opening, it was 

 found to contain a very large amniotic cavity 30 mm. in 

 length. The embo'o (10 mm. GL) is opaque and its 

 extremities are atrophic. The ehorionic membrane is 

 fibrous and separated from the decidua by considerable 

 fibrin. The decidua shows considerable inflammatory 

 reaction. The space between these two structures is 

 filled with degenerate, fibrous villi, a few buds of syncy- 

 tium, plaques of nuclear dust, and a great deal of fibrin. 



