404 Fetal Hemorrhage and Vitamin E 



often reduced to such an extent that the fetus appeared distinctly pale. This 

 pallor and the areas of vascular injury could be noted before removal of the 

 fetal membranes. 



Fetuses in which death was imminent, or had recently occurred, showed 

 more striking and irregular distention of superficial vessels, associated with 

 marked dilation of deeper vessels in the immediately vicinity. Most frequently 

 involved were the large vascular trunks at the root of the neck and their more 

 superficial branches in the lateral thoracic wall near the base of the forelimb 

 (pi. 1, fig. 3). These latter changes were almost universally accompanied by 

 prominent areas of hemorrhage in the lateral wall and floor of the cerebral 

 vesicles. Histological examination revealed extensive extravasation of blood 

 into the substance of the corpus striatum and adjacent regions of the cerebral 

 hemispheres. Similar but less extensive areas of hemorrhage were sometimes 

 encountered in other regions of the brain and in the spinal cord, tail, extremi- 

 ties, and liver. Fetuses such as depicted in plate 1, figure 3, if viable, showed an 

 almost imperceptible circulation in the vessels of the yolk sac and in the super- 

 ficial capillaries of the fetus proper, while that of the umbilical vessels was 

 diminished to a variable degree. Yet, on histological examination, the fetal 

 tissues involved by vascular congestion or hemorrhage as well as those not so 

 affected appeared normal and sometimes showed considerable mitotic activity. 



Occasionally the terminal stages of fetal life were characterized by more 

 diffuse areas of hemorrhage in the superficial tissues of the head and body 

 wall (pi. 1, fig. 4), in addition to certain of the vascular changes described above. 

 Sometimes large areas of superficial edema in the body wall and a bloody tinge 

 to the amniotic fluid were noted. It seemed incredible that fetuses with such 

 extensive vascular injury and edema could still be viable. The striking pallor 

 and vascular changes of fetuses such as pictured in plate 1 , figures 3 and 4, could 

 be noted before the uterine wall was opened. Although similar changes were 

 found in fetuses which proved to be dead on examination, they were soon 

 obliterated by autolytic changes in the fetus. 



A single protocol will serve to illustrate the diverse conditions observed in 

 fetuses at autopsy on the sixteenth day of pregnancy. 



Protocol 



Rat 3697 received 1.75 mg. of synthetic beta-tocopherol, distributed over the first ten days 

 of pregnancy; a dosage level Avhich gave a positive response in six of eleven rats tested. At 

 autopsy there were eleven viable fetuses, six in the right horn and five in the left horn of 

 the uterus. The finding in individual fetuses, beginning at the cephalic end of the uterine 

 horns, was as follows: 

 Ri — Normal 



R2 — Congestion in superficial vessels of shoulder region 

 R3 — Superficial congestion near ear, shoulder, and lateral body wall 

 R4 — Superficial congestion in extensive plexus lateral to lumbar and sacral vertebrae 

 R5 — Moderate congestion over shoulder and hip region; deep hemorrhage in right cerebrum 

 R6 — Congestion in deep vessels overlying spinal cord in upper lumbar and thoracic region, 

 and in superficial vessels around eye 



