162 



STUDIES ON PATHOLOGIC OVA. 



No. 152. 



(1) H. J. Boldt, New York. 



(2) A 70X42X38 mm.; B 31 mm. 



(3) "The specimen is from a woman suffering witn 

 endometritis, this being her third successive abortion 

 which took place in each instance during the third month 

 of pregnancy. The beginning of the last period preceding 

 this abortion took place on April 16; conception April 20 ( (), 

 and abortion June 25." 



(4) The chorion was smooth and apparently devoid of 

 villi. The cavity of the amnion was filled with a mass of 

 granular magma covering entirely an embryo over 2 

 months old. The umbilical cord was much twisted and 

 thin, measuring 0.5 mm. in diameter. 



(5) Microscopic examination shows that the chorion and 

 amnion are fibrous, thickened, and degenerate. The villi 

 of the chorion are matted together with fibrin and a mass 

 of cells which have undergone hyaline degeneration. The 

 epithelium is absent or necrotic; stroma of villi very 

 fibrous, being invaded at many points by syncytial cells 

 and leucocytes. At numerous points there are large nests 

 of leucocytes forming abscesses. It is a plain case of 

 endometritis infecting the chorion. The embryo is em- 

 bedded in a large quantity of magma and presents just 

 such a picture as No. 79, described above. The organs 

 are dissociated and macerated and the tissues stain poorly, 

 indicating that the embryo had died a considerable time 

 before the abortion took place. Again, the central ner- 

 vous system is swollen and dissociated. Migrating cells 

 are found in clumps or scattered in all of the tissues. In 

 general, the connective tissues are more fibrous than 

 normal, the derrnis showing considerable hypertrophy. 

 The epidermis is lacking. 



(6) Infiltration of the decidua; long retention. 



No. 182. 

 (1) D. S. Lamb, Washington, District of Columbia. 



(4) Head and upper end of the body of an embryo about 

 5 weeks old. 



(5) Sections show an extreme degree of disintegration. 

 The brain is converted into a mass of cells filling the central 

 canal entirely and extending into the surrounding tissues, 

 the line of demarcation being obliterated. The large 

 veins of the body are gorged with blood, which also ex- 

 tends into the surrounding mesoderm. On the frontal 

 side of the head there is a straw-colored, necrotic mass con- 

 taining some migrating cells. On the dorsal side the meso- 

 derm is thin and blistered. The cartilages alone are still 

 well denned. 



(6) Decidua and chorion absent. 



No. 212. 



(1) J. Park West, Bellaire, Ohio. 



(2) B 15 mm. 



(3) The macerated embryo is from a large ovum which 

 was aborted October 9. Last menstrual period began on 

 April 3, 189 days before the abortion. 



(5) The tissues show that its development was arrested 

 during the sixth week. The central nervous system is 

 completely dissociated, being but a mass of cells. The 

 face and top of the head have been converted into a thick- 

 ened mass of degenerated tissue, in which may be seen 

 large veins filled with blood. The eyes are immediately 

 below the skin, thoroughly dissociated, but the vesicular 

 lenses can still be outlined. 



(6) Decidua and chorion absent. 



No. 215. 



(1) D. F. Unger, Mercersburg, Pennsylvania (Erode 

 collection). 



(2) A 45X40X40 mm.; B 17 mm. 



(4) The specimen is smooth and fleshy and filled with 

 granular magma, in which were found the remnants of a 

 macerated embryo. 



(5) Sections of the chorion show that it corresponds with 

 ts history, which states that the specimen is about 12 

 weeks old. The amnion lines the whole ovum. The cho- 

 rion is thickened locally and degenerate. The villi are 

 matted together, and the stroma is non-vascular and 

 ibrous, with necrotic epithelium. The two sections of the 

 decidua present show no infiltration, but the appearance 

 of the sections and of the gross specimen suggests very 

 strongly that infection must have been present. 



No. 226. 



(1) J. Park West, Bellaire, Ohio. 



(2) A 60 X60X30 mm.; B 24 mm. 



(3) "The woman, mother of three children, menstruated 

 last on March 3 and aborted on May 29." 



(4) The ovum is covered with a few large villi, 2 mm. 

 in diameter at their base, and irregular clots of blood; 

 elsewhere it is smooth. The amnion is filled with a 

 granular mass which was easily removed. 



(5) Between the amnion and chorion there is an irregu- 

 lar mass of maternal blood. The tissues of the villi and 

 the chorion are somewhat fibrous with only a few degener- 

 ated blood-vessels in some of them, indicating that the 

 circulation had ceased some time before the abortion. 

 This is confirmed by a study of the embryo. The exter- 

 nal form of the embryo indicates that it was nearly 50 days 

 old when it died; for, with the exception of the head, its 

 form is practically normal. The menstrual history makes 

 it 87 days, and if 28 are subtracted, 10 days are still left, 

 which is time enough in which to bring on the internal 

 changes found. In general, the organs are sharply de- 

 nned, but do not stain well. The cartilages also are well 

 formed, and the maxilla, mandible, clavicle, humerus, 

 ulna, radius, femur, and tibia have begun to ossify. All 

 this indicates that this embryo died quite suddenly, and 

 that the changes within it are to be viewed as post-mortem 

 changes. The vascular system is well developed, the 

 heart-muscle being normal in shape, but very fibrillar, 

 and does not stain well. Most of the large vessels are 

 empty, the blood-cells being scattered throughout the 

 tissues of the embryo and the cord. The muscle-fibers 

 are unusually well marked, and the connective tissue 

 seems to be thickened. The most marked changes are 

 seen in the head. Much of the epidermis is still in place, 

 but some of it has fallen off. At the back of the head the 

 destructive process has included the back of the brain 

 and the upper part of the spinal cord. The forebrain, 

 midbrain, and spinal cord of the trunk are still intact and 

 dissociated. The eyes are normal in shape and position, 

 but much macerated. The nerves of the head can still 

 be outlined, which shows quite conclusively that the dis- 

 integration of the medulla is of recent date. 



(6) Decidua absent. 



No. 230. 



(1) J. Park West, Bellaire, Ohio. 



(2) A 75X60X59 mm.; B 57 mm. 



(3) "The patient has had 3 children and 3 miscarriages. 

 She always menstruates regularly during pregnancy, and 

 hence has been undecided during the past 7 months 

 whether or not she was pregnant." 



(4) Upon opening the ovum it was found that the fetus 

 was greatly cramped and embedded in much granular 

 magma. The cord is thin and knotted. The right leg 

 has a club-foot and the left a dislocated knee-joint. Evi- 

 dently the embryo had been dead for a long time. 



(5) The chorion and amnion are very degenerate, fused, 

 fibrous, and thickened. The vessels of the chorion are 

 largely obliterated. The stroma of the villi is fibrous and 

 non-vascular, and the epithelium hecrotic. The villi are 

 matted into a solid mass by fibrin and coagulum, together 

 with the degenerate decidua and trophoblast. The dislo- 

 cated knee and club-foot of the embryo show that the car- 

 tilages are markedly deformed. The liver, brain, spinal 

 cord, and eye are macerated, converted into a pulpy mass, 

 and do not stain. All of the epidermis has fallen off. 



