File:The diagnosis of diseases of women (1905) (14576573130).jpg

Identifier: diagnosisofdise00find (find matches)
Title: The diagnosis of diseases of women
Year: 1905 (1900s)
Authors: Findley Palmer. (from old catalog)
Subjects:
Publisher: Philadelphia and New York, Lea brothers & co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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are essentially hyperplasia and necrosis of the cell elements; theprotoplasm increases in amount and the nuclei in size and number.The vacuoles are in number and size directly proportionate to theamount of epithelium, and are doubtless due to degenerative changesfrom malnutrition. Coagulation necrosis of the syncytium is moreor less in evidence throughout the specimen. With the death ofthe foetus there is loss of the fetal blood supply to the villi. Thisdoes not necessarily result in necrosis of the villi, provided the DIAGNOSIS OF HYDATIFORM MOLE 181 maternal blood supply is sufficient to supply the needed nourish-ment; on the contrary, the villi may continue to grow. According to Marchand, the fetal blood is of minor importancein supplying nourishment to the villi. As evidence of this he hasdemonstrated necrosis of the stroma in the presence of a fetal bloodsupply and in the absence of a syncytial covering. His conclusionis that the syncytium exercises a governing influence over the
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5 % / . * * Group of degenerated \illi, showing proliferation of the syncytium. maternal blood supply to the stroma of the villi; when destroyedthe stroma will undergo degenerative changes. Marchand assertsthat a well-formed stroma is found only where the maternal circu-lation is adequate and the syncytium intact. It is found that in partial moles where the maternal circulationis less disturbed the necrosis of the stroma is correspondingly less.It would appear, then, that the remote cause of the necrosis of the 182 SPECIAL DIAGNOSIS chorion lies in the failure on the part of the maternal circulationleading to degeneration of the connective tissue, and to a serousexudate which finally replaces the stroma of the villi. Petersbelieves the syncytium to be a sort of endothelial layer lining theintervillous spaces and exercising some important part in the func-tion of interchange between maternal and fetal circulation. Further-more, that it serves to protect maternal blood from direct conta

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