ON THE FATE OF THE HUMAN EMBRYO IN TUBAL PREGNANCY. 



103 



uterine end of the tube. The latter shows a pronounced fol- 

 licular salpingitis with an extensive infiltration of leuco- 

 cytes. Most of the folds of the tube are adherent and the 

 network formed by them is so extensive that at some 

 points they appear to be in the tube lumen. 



Sections through the point of greatest distention show 

 that the clot is not adherent at any place. The lumen of 

 the tube is lined with folds, which are markedly inflamed, 

 but otherwise perfectly normal. There are no outpocket- 

 ings or an\' indication of follicular salpingitis. Within the 

 blood clot, which is composed mostly of fresh blood, is a 

 large collapsed ovum. The chorionic wall and the villi 

 are fibrous and atrophic. Some of the villi are undergoing 

 necrosis, and these necrotic masses have been invaded by 

 a large number of leucocytes. Radiating from the tip 

 of the villi and other points are strands of fibrin and leuco- 

 cytes, which form the characteristic stratification so often 

 seen in these specimens. 



No. 998. 



(Dr. W. H. Donaldson, Fail-field, Connecticut.) 

 Tubal mass, 85X45X45 mm. From a Hungarian 

 woman 28 years old, who had been married years, this 

 being her first pregnancy. The last period began Sep- 



tember 28, 1914, and continued for 1 days. The operation 

 was performed November 24. The left tube appeared In 

 be normal and the uterus was enlarged to twice its normal 

 size. The pregnancy was in the left tube. Venereal 

 disease was denied. The specimen consists of a tubal 

 mass, 85X45X45 mm., which has been cut open, exposing 

 a cavity 20X15 mm. The cavity is lined with a smooth, 

 glistening membrane. No embryo is found, but her physi- 

 cian states that at the time of the operation a beautiful 

 embryo was seen when the tube was opened. 



The section through the uterine end of the tube shows a 

 pronounced follicular salpingitis. The tube is cut up by 

 fibrous anastomosing bands, the follicles being filled with 

 processes, some of which also anastomose. The section 

 could almost pass for that of an organ. A section throvigh 

 the hemorrhagic mass includes also the tube wall. It is 

 composed of mottled blood, containing many necrotic and 

 fibrous villi. In the neighborhood of the fresh blood some 

 of the trophoblast is active. The chorionic wall is also 

 fibrous and at some points the amnion can be easily seen. 

 The tube wall is more or less adherent and is often exten- 

 sively inflamed and encircles the clot. Nearly the entire 

 mucous membrane is intact and shows an extensive fol- 

 licular salpingitis. 



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