Gynecological diagnosis and pathology . t an exact diagnosis can onlybe made by curettage. When this is done it is found that the cervixis not easily dilated, and that the curette grates at once on the fibroustissue. As a rule only small fragments of endometrium can be examination of these establishes the diagnosis. RETENTION OF PRODUCTS OF CONCEPTION 93 RETENTION OF PRODUCTS OF CONCEPTION. When an ovum in expelled, cither ai lull time or in the earlier months,there ought to come away with it the whole of the decidua lining theinterior of the uterus, separation taking place
Gynecological diagnosis and pathology . t an exact diagnosis can onlybe made by curettage. When this is done it is found that the cervixis not easily dilated, and that the curette grates at once on the fibroustissue. As a rule only small fragments of endometrium can be examination of these establishes the diagnosis. RETENTION OF PRODUCTS OF CONCEPTION 93 RETENTION OF PRODUCTS OF CONCEPTION. When an ovum in expelled, cither ai lull time or in the earlier months,there ought to come away with it the whole of the decidua lining theinterior of the uterus, separation taking place through the spongy some cases, however, this complete expulsion does not occur andfragments of decidua and chorion may lie left behind. In many casessuch fragments are expelled spontaneously at a later date, but in othersthey remain attached to the uterine wall for considerable periods. Suchretained products interfere with the involution of the uterus and leadto a persistence of the haemorrhage which accompanied the labour or. Fig. 89.—Scraping from Case of Incomplete Abortion. In the lower part of the section is a mass of degenerated decidual cells, in the upper part a chorionic villus. abortion. The retained decidua may remain active for some time butgradually undergoes a process of degeneration. The chorionic villi quicklydie, their epithelial covering degenerates and disappears, and after a timeall that remains of them is their connective-tissue cores, which also aredegenerated. The appearances presented by the tissue removed by thecurette from such cases vary therefore with the time which has elapsedbetween the abortion and the date of operation. Fig. 89 shows the tissueremoved two weeks after an incomplete abortion. The decidual cellshave begun to degenerate, the protoplasm is vacuolated, the nucleishrunken. The chorionic villus still retains its epithelium, but it alsohas begun to degenerate. Fig. 90 is a section of tissue removed several 94 GYNECOLOGICAL PAT
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
