On the production of endometrial moles with steroid hormones

HAMILTON

:

69

ABORTION

6. Spontaneous abortion was no more frequent in first pregnancies than in those of higher order, Induced abortion increased with order of pregnancy. That is, the probability of an abortion being induced, all things being equal, increases with the number of pregnancies the woman has previously undergone. This does not apply to pregnancies of very high order (10 or more). Of these there were too few in the present series to furnish a basis for conclusion. 7. Low sedimentation rate, fever, leucocytosis and acute inflammation of the decidua and chorion were found to be more frequently associated with mechanically induced abortion than with drug-induced or spontaneous. These evidences of infection were, however, by no means confined to t,he former group. 8. The Wassermann test was positive in 5 per cent of drug-induced and of spontaneous, in only 1 per cent of mechanically induced abortions. 9. Low hemoglobin determinations were not significantly more frequent in any one category than in the others. 10. Bacteriology showed little correlation with history in this series. The fact that here cervical culture cast scant light on differential diagnosis or prognosis should not lead to the conclusion that it is of no value. Infection with the virulent hemolytic streptococcus is relatively rare (it did not appear in this series), but i6s prompt recognition is of vital importance. 11. Curettage was performed in 59 per cent of the mechanically induced group, 68 per cent of the drug-induced, and 71 per cent of Operative mortality was 0.6 per those claiming spontaneous abortion. cent. Average stay in the hospital of curetted patients was five to seven days. The author wishes to express the photomicrograohs illustrating without which this study woulrl

her

deep appreciation this paper and

not have

been

for

possible.

to Dr. William his interest

and

E. Studdiford encouragement

for

REPFRENCES

Brit. Emp. 31: 769, T. g) Pearce, T. 7.. . J. Obst. & Gynaec. . : South. M. J. 28: 645, 1935. (3) Pasmore, H. 8.: J. AM. J. OBST. & GYNEC. Emp. 44: 455, 1937. (4) Simons, H.: Brit. M. J. 1: 1045,, 1938. (6) Studdiford, W. Cook, R. G.: AK J. OBST. & J. Xed. 39: 1274, 1939. (7) Ha,mrlton, P. C.: AM. J. OBST. & GYNEC. 31: 1029, 1935. (8) Drane, W. H.: Calif. & West. Med. 37: 368, 1932. (10) Brown, T. K., and OBST. & GYNK. 32: 804, 1936.

Selye, Hans and Friedman, Sidney: On the Production With Steroid Hormones, Am. 5. Cancer 38: 555, 1940.

1930. Obst. 37:

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Hunt,

(2) Bodeware, & Gynaec. Brit. 840,

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(5)

New

York

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39:

919,

DePuy, G. A.:

1940.

C. A.: AM.

of Endometrial

J.

Moles

Leo Loeb as the first showed that the uterus, if traumatized while under the influence of an active corpus luteum, responds by the formation of structure not unlike the maternal portion of the placenta. This growth may become quite large and assume the appearance of a decidual tumor. Investigations by the writers demonstrated that uteri of postpubertal ovaricctomized rats treated with daily doses of 100 gamma of estradiol, 3 mg. of testosterone, or 3 mg. of pregninolon are sensitize,d to local trauma in such a manner that gelatinous tumors of the endometrial mole type develop at the site of injury. These observations give further support to the concept that both local injury and an appropriately prepared humoral medium are essential for tumor production. HUGQ

EHRENFEST,