Ectopic pregnancy; its etiology, classification, embryology, diagnosis and treatment.

  • Webster, John Clarence, 1863-1950.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Ectopic pregnancy; its etiology, classification, embryology, diagnosis and treatment. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    formed from the size of the placenta. Variations also occur in the size of the foetus, and the size relationship between foetus and placenta is different in different cases. It will not do, therefore, to compare one specimen with another without taking into account these individual variations. To prove the truth of the statement, it would be necessary to estimate, by some accurate method, the size of the placenta before and after the death of the foetus, and to show by the microscope the seat and amount of the alleged growth. That correct observations have been made in many instances as to tliG increase in size, of the placenta, after the death of the foetus or its removal by operation, cannot be disputed. The explanation of this increase as being due to groivth is the mistake that has ieen made. The change in the size of the placenta is due not to growth of its tissue, but to extravasations of maternal blood, varying in size and number, which alter the continuity of the villi and their relations to one another. I have already pointed out (p. 73) the constant tendency to the occurrence of hsemorrhages in the placenta of ectopic gestation. This tendency occurs through the whole of preg- nancy, and is probably especially marked, as Hart says, in the subperitoneo-abdominal form, in which the placenta is situated above the foetus, and is consequently displaced in its growth. The haemorrhages may be few, small, and separate; they may be close together, and the general shape and size will not be greatly altered. But they may be so excessive that the placenta, from having been a discoid mass, may be changed to a thick ovoid or rounded mass, consisting of blood clot, in which are found scattered the torn up and broken villi. The colour of the placenta varies also according to the amount of organisation of the hsemorrhagic masses. There may thus be