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.

    12/134 (page 370)
    In the first place, the placenta, in a case of syphilis, is frequently bigger than normal. The weight of the placenta varies to a certain extent with the size of the child, and generally corresponds to about one-sixth of its weight. In cases of syphilis it may attain a size equal to one-fifth or even one-fourth of the foetal weight. Pinard has pointed out that syphilitic children born alive at full term are often* themselves unduly big, and at the same time the amount of liquor amnii present is frequently in excess of the normal amount. Thus in cases of syphilis we may get what Pinard describes as a ‘ big egg ’ {gros osuf). So much is he impressed with the importance of this sign that he makes it a rule that a child born with an unusually large placenta shall be suckled only by its mother. He considers that the increased volume of the placenta is most often seen in, if not entirely confined to, those cases in which infection occurred previous to conception. In such a placenta the sulci between the lobes are generally deep and the cotyledons are thus strikingly mapped out. In colour it is paler than normal with yellowish-white patches. The substance of the placenta is often softer and more friable than usual, and on section shows a peculiar mottled appearance which has been compared to sausage meat. To the naked eye the vessels of the cord may show thickening of their walls. Exten- sive changes in the umbilical vessels, leading as they do to throm- bosis, are inconsistent with foetal life, and therefore are not observed to any marked extent in cases where the child is born alive. Slight irregular thickenings of the vessel walls are common in the cord quite apart from any syphilitic infection (see also vol. i, p. 133, and Plate XXXIII). When the foetus is dead the cord often presents an oedematous appearance, and the golden-coloured thickened vessels may then be seen shining through the brown and swollen cord. Absence of Whartonian jelly, with separation of the vessels, has been described by Mace and Durante as occurring in syphilis. # The liquor amnii, as above stated, is frequently present in excess, but hydramnios is by no means pathognomonic of syphilis. It is frequently met with in diseases of the foetus and may possibly be accounted for in cases of syphilis by the lesions which have occurred in the placenta and liver. The source of the liquor