158 



STUDIES ON PATHOLOGIC OVA. 



No. 7236 4 . 



(1) Lawrence L. Iseman, Chicago, Illinois. 



(2) A 40X25X25 mm.; B 12mm. 



(4) The ovum has very thin walls, and attached to one 

 pole are a few atrophic villi. It contains an embryo 12 

 mm. long. The form of the chorion appears normal. 



(5) The mesenchyme of the villi is almost wholly non- 

 vascular, has undergone marked mucoid degeneration and 

 contains some Hofbauer cells. The trophoblast is not 

 well defined, and between the villi there are strands of 

 mucoid substance inclosing many buds of syncytium, some 

 of which are vaeuolated. The embryo is macerated and 

 markedly dissociated. The front of the head is atrophie; 

 the large blood-vessels are distended with blood, but their 

 walls are indefinite. The same is true of the heart. 



(6) Decidua absent. Hydatiform degeneration. 



No. 727. 



(1) B. J. Merrill, Stillwater, Minnesota. 



(2) A 55X35X33 mm.; B 9 mm. CR. 



(3) Patient 36 jears old; married 9 years. Three chil- 

 dren, born May 9, 1906, March 15, 1908, and August 4, 

 1910. This is her first abortion. Last menstrual period 

 April 18 to 21, 1913; abortion June 12 following. Patient 

 thinks conception could not have taken place until the 

 last of April or the first of May. Condition of uterus 

 normal. No venereal diseases. Family fertile. 



(4) The specimen is a smooth vesicular mole with ragged 

 villi, and measures 55X35X33 mm. The amnion, 

 which measures 30X20 mm., fills nearly the entire cho- 

 rionic cavity. Hanging within it is a stunted embryo 

 with knob-like arms, legs, and tail. The front of the 

 head is round, and the embryo is well bent upon itself. 



(5) Attached to the chorionic membrane are a few 

 fibrous villi with Hofbauer cells and considerable blood 

 and mucoid substance between them. The fibrinoid sub- 

 stance over the villi is thickened with overlying decidua, 

 thin and markedly inflamed. The embryo shows exten- 

 sive dissociation. The front of the head and extremities 

 are atrophie, and the latter markedly dissociated. There 

 are numerous epithelial warts protruding from the skin. 

 The organs can be fully outlined, and the peripheral 

 nerves are well formed. The heart and blood-vessels are 

 filled with blood. 



(6) Marked endometritis and early hydatiform degen- 

 eration. 



No. 732. 



(1) T. W. Harvey, Orange, New Jersey. 



(2) A 80X45X45 mm.; B 19mm. 



(3) Patient aged 29 years; married December 1911. 

 Two pregnancies normal birth September 1912, and this 

 abortion. Last menstrual period April 26 to 28, 1913, 

 and abortion July 23 following. Condition of uterus 

 normal. 



(4) The specimen is a pear-shaped mass, measuring 

 80X45X45 mm., the "pointed" end consisting of placental 

 tissue and blood-clot covering the ovum wall, while the 

 bulbous end consists of the unruptured chorionic sac, 

 which is covered with delicate villi about 10 mm. long, 

 except in the somewhat denuded areas, over which they 

 are scattered irregularly. The wall of the mass is about 

 2 mm. in thickness and lined throughout with amnion. 

 Upon opening the chorion at the denuded area, the dis- 

 tended amnion was seen as a separate sac, containing a 

 macerated embryo with rounded head and possibly atro- 

 phie arm and leg. 



(5) The chorionic wall, which appears quite normal in 

 structure, is surrounded by a mass of coagulated blood 

 containing a few fibrous villi. The fibrinoid substance is 

 greatly increased in thickness and is separated by blood 

 from the surrounding decidua, which shows slight general 

 and more decided local infiltration. The embrjo is both 

 macerated and dissociated, and the front of the head and 

 abdominal wall are missing. The viscera are embedded 

 in a mass of magma, showing that the abdominal wall was 



destroyed before the abortion. In the lumbar region the 

 vertebral column is bent forward towards the protruding 

 viscera. The tissues of the extremities and heart are 

 markedly dissociated. 



(6) Slight general infiltration of the decidua. 



No. 739. 



(1) F. B. Bowman, Hamilton, Ontario. 



(2) A 70X70X70 mm.; B 17 mm. 



(3) The patient was a Polish woman, who was in the 

 hospital only 4 or 5 hours. 



(4) The chorion, which measures 70 mm. in diameter, 

 is spherical and covered with patches of irregular villi 

 over one-half of its surface. The interior is taken up by 

 a large amniotic cavity , leaving a wall only 3 mm. thick. 

 Floating free within this cavity was a macerated embryo 

 from which the viscera had fallen out. The embryo, 

 straightened, measures 17 mm. long, and has a round, 

 knob-like head and knob-like extremities. 



(5) Sections of the chorion, which include the amnion, 

 show that it is surrounded by fairly well formed villi, 

 from which numerous buds of syncytium extend. The 

 stroma of the villi is degenerate and mainly non-vascular. 

 There also are large clumps of trpphoblast which have 

 undergone almost complete fibrinoid degeneration. Sur- 

 rounding the villi is a layer of fibrinoid substance which 

 in turn is followed by an inflamed decidua. Otherwise 

 the intervillous spaces are rilled with a clear fluid. The 

 embryo, which is distorted and macerated, shows marked 

 dissociation in the extremities and vertebral column. The 

 epidermis contains some warts of epithelial cells. 



(6) Marked infiltration of the decidua; some hydatiform 

 degeneration. 



No. 752. 



(1) Thomas J. Simms, Baltimore, Maryland. 



(2) A 65X40 mm.; B 21 mm. 



(3) Patient aged 31 years; married October 15, 1902. 

 Eight pregnancies; last confinement February 17, 1912. 

 Previous abortion in January 1910. Menstruation regu- 

 lar, lasting 5 to 6 days. Did not know she was pregnant. 

 Abortion August 29, 1913. No infection of uterus; no 

 venereal diseases. Patient belongs to a small family. 



(4) Ovum turned inside out, and measures 65X40 mm. 

 Its wall is very thin, with smooth, hermorrhagic protuber- 

 ances on the inside. An embryo 21 mm. long (CR), with 

 an atrophie head and face, is attached to the chorion by 

 means of a thickened umbilical cord. 



(5) The chorionic wall is thickened, somewhat fibrous, 

 and only a few necrotic villi ramify through the blood- 

 clot. Most of the trophoblast also is necrotic. On the 

 outside is a small layer of necrotic decidua which shows a 

 marked inflammatory reaction. The tips of the villi are 

 encircled with old fibrin clots, while fresh hemorrhages are 

 in the intervillous spaces, causing protuberances of the 

 chorionic membrane into the chorionic cavity. The 

 amnion and chorion are closely adherent, and where far 

 apart are bound together by an excessive mass of magma 

 fibrils. The embryo shows considerable dissociation, espe- 

 cially within the extremities. The macerated brain almost 

 entirely fills the head, which is reduced in size. 



(6) Intense infiltration of the decidua. 



No. 7716. 



(1) B. T. Terry, Brooklyn, New York. 



(2) B 8 mm. long. 



(3) Patient aged 29 years; married in June 1910. Three 

 pregnancies two births, September 1911 and December 

 1912, and this abortion, September 11, 1913. Last men- 

 strual period July 7 to 12. Conception must have taken 

 place July 15. Condition of uterus apparently normal. 

 No venereal diseases. Family fertile. 



(4) The embryo is a curious nodular mass, 8 mm. long, 

 with a round head running to a knob in front, atrophie 

 arms and legs, and a distended umbilical cord. 



