Syphilis in obstetrics / by William J. Gow.

  • Gow, William J.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Syphilis in obstetrics / by William J. Gow. Source: Wellcome Collection.

    14/134 page 372
    liferation and haemorrhages are frequent. A round-celled infil- tration occurs and the epithelial cells often undergo a fatty or granular degeneration (see vol. i, p. 133 and Plate XXXIII). The so-called gummata of the placenta may be the result of haemor- rhages or the result of an obliterating endarteritis similar to that which causes the infarcts so often found in the normal placenta. An attempt was made by Fraenkel in 1873 to distinguish changes produced in the placenta according as the virus was transmitted to the ovum by the father or by the mother. He thought that in cases of syphilis derived from the father the foetal structures such as the villi and their vessels were the parts chiefly affected, whereas in cases where the source of the syphihs was maternal, the decidua showed the chief changes. In the present state of our knowledge it seems better not to attempt to make any such distinctions. Changes in the chorion are much less marked than those met with in the placenta, but not infrequently it is found to be thickened, and on microscopic examination shows changes of a similar nature to those found in the placenta, that is to‘say, evidence of periarteritis with a round-celled infiltration. The decidua basalis shows signs of the same vascular change with small nodules in it formed by masses of round and embryonal cells. Since the discovery of the Spirochaete pallida efforts have been made to demonstrate its presence in the placenta, but this has not been attended with so great a measure of success as might have been anticipated. Wallich and Levaditi ('Ann. de Gyn. et d’Obst.’, 1906) investi- gated thirteen placentas, in six of which the existence of syphihs was certain, whilst in seven it was suspected. In five cases the spirochaete was searched for in sections, but was only found in one case. This was an undoubted case of syphilis as evidenced by the presence of pemphigus and visceral lesions in the foetus. The appearance of the placenta in this case showed nothing abnormal on naked-eye examination, nor was it increased in weight. Spiro- chaetes were found in considerable numbers in different parts of the foetal placenta. Thus they were demonstrated in the walls of the larger vessels given off from the cord, lying in a concentric
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