STUNTED CYEMATA. 



159 



(5) The embryo is markedly dissociated. The head is 

 small, being filled entirely by the brain-tube, and on the 

 dorsal side there is a curious vesicle under the skin, prob- 

 ably the otic vesicle. The heart can be outlined, but the 

 abdominal organs are almost completely dissociated. The 

 peripheral nerves are seen in the trunk. 



No. 776. 



(1) William Kirk, Troy, New York. 



(2) A 45X30X25 mm.; B 13 mm. 



(4) The chorion, which had been opened, measures 

 45X30X25 mm. The embryo, which is 13 mm. (CR) 

 long, has atrophic arms and head, displaced eyes, and was 

 eviscerated. 



(5) The chorion is thickened and hemorrhagic, and is 

 composed of a fibrous membrane and a few long, fibrous, 

 degenerate villi radiating through the blood-clot. The 

 periphery of the clot shows marked inflammatory reac- 

 tion. At points where the villi protrude into the spaces 

 there is a fairly active trophoblast. The macerated and 

 dissociated brain fills the entire head; the vertebral column 

 is markedly kinked and the extremities are dissociated. 

 The right eye is encircled by a thickened layer of round 

 cells which also invade its lens. The left eye is placed in 

 front and on top of the head over the midbrain, lying 

 directly under the skin. It communicates with the brain 

 through a short optic stalk. The lens contains a cavity 

 into which its posterior layer projects. 



(6) Marked infiltration of the decidua. 



No. 788 a, 6. 



(1) Anfin Egdahl, Menomonee, Wisconsin. 



, (a) Ovum 60X45X40 mm.; stunted em- 



^91 T % bryo CR 17 mm. 



1 (6) Ovum 65X55X40 mm.; nodular em- 

 * bryo 2 mm. long, group 4. 



(3) Norwegian woman, aged 32 years, married 10 years. 

 Three previous pregnancies. This abortion, which is the 

 first, occurred July 2, 1913. Condition of uterus normal. 

 No history of venereal disease. First twins known in 

 family. 



(4) a. This specimen measures 60X45X40 mm. 

 Half of its surface is formed by a transparent membrane, 

 which was found upon opening to be the greatly distended 

 chorion and amnion, containing an atrophic embryo 17 

 mm. CR. 



(5) The chorion and amnion are thickened and fibrous, 

 the villi irregularly formed, non-vascular, and undergoing 

 mucoid degeneration. They are encircled by consider- 

 able fibrinoid substance and a hemorrhagic and inflamed 

 decidua. The intervillous spaces have within them con- 

 siderable trophoblast, some of which is necrotic. There 

 is a fair amount of activity in the syncytium, some of 

 which has been converted into nuclear dust. The embryo 

 is dissociated, but all the organs can be outlined. The 

 front of the face is attached to the thorax. 



(6) Mild endometritis. 



No. 802. 



(1) W. G. Sexton, Baltimore, Maryland. 



(2) A 19X26X16 mm.; B 6mm. 



(3) Patient aged 29 years; has had four normal preg- 

 nancies and two miscarriages. One week before operation 

 patient began to have abdominal pain and slight bleeding. 

 The bleeding continued until the time of admission to 

 the hospital. At times she passed large clots. At the 

 operation the entire placenta was removed and the uterus 

 curetted. 



(4) The ovum is well covered with villi, excepting at 

 one pole, which is bare. It was carefully opened through 

 this area, and a well-formed embryo CR 6 mm. was found 

 encircled by a somewhat opaque amnion. 



(5) The villi are well defined, and the chorionic wall is 

 normal in structure. The villi are matted together and 

 do not have the usual clear mesenchyme. The stroma, 



which is somewhat macerated, contains degenerating ves- 

 sels. The trophoblast is very irregular, most of it necro- 

 tic, and numerous small buds of syncytium are attached 

 to the villi. The body of the embryo is normal in form, 

 and sections indicate that its organs are well denned and 

 apparently normal, with the exception of some dissocia- 

 tion, which is especially well marked in the cells of the 

 large blood-vessels; that is, the blood appears to be dif- 

 fusing through them. The head is atrophic, the brain 

 badly dissociated and very small, and the eyes are round 

 and reduced in size. 

 (6) Decidua absent. 



No. 872. 



(1) Charles E. Brack, Baltimore, Maryland. 



(2) A 38X28X30 mm.; B 13 mm. 



(3) Woman aged 40 years; married in 1896. Eight 

 term pregnancies and three miscarriages. Abortions be- 

 tween second and third child, between sixth and seventh, 

 and after the eighth. Last menstrual period January 18 

 to 25; abortion April 17 following. Patient was ill after 

 the middle of February with nausea, languor, and chilly 

 sensations. Size of specimen did not correspond with 

 period of amenorrhea. Condition of uterus normal. No 

 venereal diseases. Family fertile. 



(4) The specimen consists of an abortion mass, measur- 

 ing 55X35X35 mm., and seems to be mainly decidual 

 tissue from which the spherical and distended ovum has 

 freed itself. The ovum measures 38X28X30 mm., and 

 is covered on one side by luxuriant villi which attain a 

 length of 12 mm. On the other side it is bare and 

 transparent. Opened in the denuded area, an opaque, 

 stunted embryo and yolk-sac are seen. The embryo is 

 still attached to the chorion by a short, clear umbilical 

 stalk. It measures 13 mm. GL. The neck has been torn 

 ventrally, so that the head is somewhat more extended 

 upon the body than previously, and therefore the length 

 recorded is too great. The head, arms, and legs are 

 atrophic. Lying about 8 mm. distant from the embryo 

 is a thin-walled but opaque yolk-sac, measuring 4X6 

 mm. The amnion lines the entire chorion. The villi are 

 irregular in size, ragged, and suggest the presence of hydati- 

 form degeneration. 



(5) Upon microscopic examination the hemorrhagic de- 

 cidua shows the presence of considerable autolysis. Some 

 portions are composed wholly of the usual large polygonal 

 cells, but in other areas cells of the fibroblast type prevail. 

 These not infrequently show a tendency to streaming or 

 arrangement in whorls. No indication of infection is 

 present. 



The chorion, amnion, and villi, though macerated, are 

 relatively well preserved and the latter distinctly hydati- 

 form in structure. Considerable epithelial proliferation is 

 present and the nodules are degenerate. Epithelial mi- 

 grations are present in some villi, but only relatively 

 small syncytial buds are present on the chorionic mem- 

 brane. In many regions the epithelium is still distinctly 

 two-layered. Hofbauer cells, especially transitional in 

 type, are quite common. 

 " (6) Hydatiform degeneration. 



No. 880. 



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



(2) B 10.5 mm. 



(3) Patient 34 years old. Has two children, both living. 

 No former abortions. Menstruated last November 5; 

 suddenly developed "cramps" February 3 following. 

 Expelled membranes containing fetus the same day. She 

 did not suspect her condition because of menstrual irregu- 

 larity. At times she does not menstruate for several 

 months. This is probably due to anemia. Age of embryo 

 estimated at 8 weeks. 



(4) The specimen consists of a pathological embryo, 

 measuring 10.5 mm. CR, 11.2 GL, and 11.2 NL. The 

 left side of the body has suffered grave mechanical injury, 

 the legs having been removed, the muscles, ribs, and nerves 



