Cervical decidua / by Frank W. Lynch.
- Lynch, Frank W. (Frank Worthington), 1871-1945
- Date:
- [1913]
Licence: In copyright
Credit: Cervical decidua / by Frank W. Lynch. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
5/12 page 3
![for 3 to 4 mm., below which on the crest of the arbor vitae were seen areas of typical decidual cells, even as far down as the externa] os. The cervix appeared very vas- cular. Ponfick in 1899 presented two cases associated with cervical placenta praevia. In the first specimen the entire upper portion of the cervical division was filled with placental tissue, which extended down as far as the ex- ternal os in tongue-shaped processes, closely adherent to the underlying tissue. The sec- ond case also presented a cotyledo praevia with a condition in the cervix similar to his other case. Kronig in 1901 describes the lower uterine segment and cervix of a 19-year-old girl who died in the ninth month of pregnancy from cardiac disease. I'he child was recovered by Caesarean section during the death agony. The placenta was normally situated. Some areas of decidual cells were seen in the upper cervix. Volk in 1903 presented a case of unusual interest. During the examination of a luetic Il-para the everted cervix was found to be the seat of several reddish patches of millet-seed size which bled upon slight trauma. A sec- tion was taken for diagnosis three v/eeks before the onset of labor at term. The cervical tissue presented considerable mdema, while the plaques under investigation were found to consist of decidual tissue. Similar areas were seen underneath the healed erosions. In order to ascertain the frequency of decidual reaction in the cervix in jjlacenta j)rievia, he removed a section from the anterior cer\ical wall of a woman recently delivered. The gross appearance of this lip suggested the pres- ence of decidua, which was subsec|uently demonstrated by sections. Walflstein’s case, in 1903, was a twin preg- nancy in a \T-])ara. The placenta was laterally imi)lanted. rost-jiartum Ifieeding suggested a torn cervix, anfl when retractors were applied numerous ])la(jues appeared to view, suggesting a carcinomatous change. Sections taken for diagnosis from the vascular cervix gave a picture of a healed erosion, with large and small nests of decidual cells in the neighborhood of the external os, on the cervi- cal flaps, and also under the eroded flap of the portio vaginalis. Hohmeier in 1905 investigated the cervical mucosa in 7 cases in various stages of preg- nancy or immediately after birth. Decidua in the lower two thirds of the cervix was seen in 4 cases; twice with placenta praevia and twice with normally situated placentae. The reaction varied in extent, sometimes being broad and extensive while in other specimens it was limited, as in the case of Volk. Blumberg in 1905 reports a V-para who had been bleeding off and on until her fifth month of pregnancy, when examination disclosed several gray polyps the size of a bean in a large, soft, and somewhat dilated cervix. Three of the polyps were removed for examination and the labor terminated. There was placenta pra,'via. The polyps were found to be the seat of decidual change. His second case is that of a case which entered the Landau clinic with bleeding from retained secondary post- abortum. The day following their removal severe hccmorrhage indicated inspection of the os. Several granular areas were seen on the cervical lips, some of which were removed and found to be the seat of decidual formation. Taussig, in his paper before our Society, reported a case of great interest on account of the multiple locations presenting decidual formation. The case was a primipara of 35 years in which a tubal pregnancy was associat- ed with multiple uterine myomata, a cystic adenomyoma, and a parovarian cyst. The pregnancy occurred in the fimbrica ovarica, and by the spread of the placenta upon the posterior peritoneum became a case of sec- ondary abdominal pregnancy. Decidua for- mation was found in the uterus, on the poste- rior uterine peritoneum, in the non-pregnant tube, in the parovarian cyst, in })eritonea] adhesions, and in the cervix. The decidua noted in the cervix presented in the region of the internal os and for i cm. below, but could not be demonstrated in the lower cervical canal. It is more than possible that the case of Seitz docs not belong in this list, yet it deserves consideration on account of its many peculiar features. A woman 41 years of age, who had had nine children and two abortions, was](https://iiif.wellcomecollection.org/image/b22466678_0007.jp2/full/800%2C/0/default.jpg)
