FETUS COMPRESSUS. 



165 



chorion is detached it keeps on growing in an irregular 

 fashion, for the villi are in fresh hemorrhages. Sections 

 of the embryo show that cartilages have been well formed. 

 In some places the ossification centers stain with hema- 

 toxylin; otherwise the tissues are markedly macerated. 

 Since none of them gives a differential stain, the embryo 

 no doubt had been dead for a long time before the abor- 



tion. 



(6) Some infiltration of the decidua; long retention. 



No. 622. 



(1) H. T. Collenberg, Baltimore, Maryland. 



(2) A 80X40X15 mm.; B 70 mm. 



(3) Patient aged 30 years, with three children living and 

 apparently healthy. This is the third miscarriage. The 

 others were early and likely not induced. Fetus was 

 expelled after 24 hours of pain. No menstruation for 9 

 months. 



(4) The specimen consists of an unopened membrane 

 with placenta. The contents of the amniotic cavity con- 

 sist of a dark-brown fluid and the macerated fetus. The 

 latter measures CR 70 mm., is very much distorted and 

 slender, with a head greatly reduced in size. The extremi- 

 ties are very much deformed, with club hands and feet, 

 and the left forearm is adherent to the shoulder. The 

 cord is nodular and atrophic. 



(5) The placenta, which was cut at the attachment of 

 the cord, was found to be fibrous. The villi are packed 

 together with an almost continuous mass of necrotic 

 trophoblast and show considerable invasion by leuco- 

 cytes. Occasionally some activity is shown in the tropho- 

 blast. Most of the villi are fibrous and others do not 

 stain well. They are all degenerate, even necrotic, and 

 are glued by degenerate blood, epithelium, and tropho- 

 blast. Throughout the entire specimen large plaques of 

 nuclear dust indicate that the tissues had been dead some 

 time before the abortion. 



(6) Marked infiltration of the decidua; long retention. 



No. 627. 



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



(2) A 80X50X35 mm.; B 45 mm. 



(4) The specimen consists of a solid mass, 40X30X25 

 mm., to which is attached a large vesicle, measuring 

 80X50X35 mm., and undoubtedly representing the 

 distended amnion. Within the latter, which is filled with 

 clear fluid, there is a distorted embryo with an extremely 

 small and very much twisted umbilical cord. Over the 

 legs, on one cheek, and on the back of the head there are 

 large vesicles which seem to involve only the skin. The 

 one over the back of the head is 15 mm. long and 8 mm. 

 wide. Caudal to this and running down the middle of 

 the back there is a marked fibrous ridge. The hands, 

 especially the fingers, appear as if deformed. 



(5) Sections made in the neighborhood of the attach- 

 ment of the umbilical cord show the vessels of the latter 

 with indistinct walls but filled with blood. The villi have 

 largely undergone fibrous degeneration, and most of the 

 trophoblast has been converted into nuclear dust, although 

 some have fibrinoid substance only within their centers. 

 There also are left rounded islands of trophoblast. 



(6) Marked infiltration of the decidua; changes sug- 

 gestive of lues. 



No. 646. 



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



(2) A 90X60X50 mm.; B 85 mm. 



(4) The chorion, which measures 90X60X50 mm., 

 was empty, the amniotic sac having slipped out. Within 

 the latter was a macerated, edematous fetus, with a dis- 

 torted head from which the brain is protruding. There 

 are marked contractions in the forearms, and the fingers 

 of the right hand are nearly amputated. From their 

 knob-like stumps extend numerous delicate fibrils. As 

 they strip off so easily, it is probable that they are com- 



posed exclusively of macerated epidermis. The umbilical 

 cord is very thin and greatly twisted. The chorion is 

 covered with large, shaggy villi, showing that implanta- 

 tion had been well established before the abortion. 



(5) Sections through the cord show that it has under- 

 gone degeneration; sections through the hand show the 

 dissociation of the periphery of the cartilages and muscles. 

 In other words, there is an infiltration of cells between the 

 muscle-fibers. 



(6) Decidua and villi absent. 



No. 649. 

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



(4) The body and extremities of this specimen are much 

 out of proportion. There is a large tumor on the back of 

 the head, the spinal column is bent upon itself, and the 

 viscera hang out in an enlarged bag in front. From one 

 side of this bag the umbilical cord arises. 



(5) The most marked abnormalities of this specimen are 

 total spina bifida and defective posterior portion of the 

 cranial vault. The spinal column consists of 31 verte- 

 bral bodies. This includes the coccyx, but not the atlas, 

 which could not be traced. Along the sides of the verte- 

 brae there are present rudimentary, cartilaginous neural 

 processes. The spine is in sharp dorsi-flexion in the upper 

 cervical and lower thoracic regions, with a more rounded 

 and probably compensatory kyphosis below these areas. 

 All that remains of the spinal cord is a strip of thin mem- 

 brane into which the spinal nerves run fairly regularly 

 ventrally. The anterior vault of the cranial cavity is 

 flattened so that it is reduced to a narrow slit, and the 

 defective contents of the cranium project backwards into 

 a sac which lies over the spinal column. This sac con- 

 sists of several layers of membranes. The remains of the 

 nervous system which it contains are quite elongated 

 nerves and shreds of much-folded membranous tissue. 

 (Wheeler.) The ribs are very crowded and show a ten- 

 dency towards fusing. In the forearms both ulnse are 

 present; 4 metacarpals and 4 phalanges; the radii and 

 thumbs are lacking. In the legs the bones are all present, 

 but the positions are anomalous. There is extreme exter- 

 nal rotation, with the soles of the feet directed backward 

 and inward (equino-varus). There is ectopia viscerum, 

 the liver, intestines, stomach, spleen, and pancreas pro- 

 jecting outward into a rounded sac. Several subcutaneous 

 blebs are scattered over the surface of the sac, and the 

 stumps of the cord attached to it show marked mucoid 

 degeneration. There is a Meckels diverticulum; the dia- 

 phragm is bilaterally defective; the lungs are abnormally 

 formed and lie next the kidneys. The adrenals could 

 not be traced. 



No. 717. 



(1) Max Emmert, Atlantic, Iowa. 



(2) A 50X45X35 mm.; B 14 mm. 



(3) Patient is 34 years old: married June 1907. First 

 abortion February 1908, at 3 months. Last menstrual 

 period April 7 to 10, 1913; abortion June 5 following. 

 No infection of uterus; no venereal diseases. Patient is 

 one of two children. 



(4) The specimen measures 50X45X35 mm., and 

 consists of a vesicular chorion covered partly by a few 

 ragged villi and partly by infected decidua. The cho- 

 rionic wall is very thin, and the cavity contains a clear 

 fluid and a granular deposit. There also is a small mass 

 of granular magma on one side, a macerated cord 10 mm. 

 long and a floating remnant of an embryo 14 mm. long. 

 The latter can barely be outlined. One arm and the 

 atrophic legs are still intact. A slight amount of shaking 

 would cause the entire specimen to fall to pieces. 



(5) The chorionic membrane and amnion are thin and 

 fibrous. The villi are atrophic and some are fibrous. 

 Between them there is a considerable amount of mucoid 

 substance and blood, containing numerous buds of syn- 

 cytium. The entire mass is surrounded by a thin layer 



