The Principles And Practice of Obstetrics

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Separation of the ovum occurs in the spongy layer of the decidua, and since the regressive changes — the necrosis — have not progressed far, this is often incomplete, and pieces of membrane or r>lacenta are likely to be retained, especially in the tubal corners. One may, therefore, distinguish three fairly well- defined periods: First Period. — In the first six to eight weeks the whole ovum is usually born, covered by the decidua, and it is often possible to reconstruct the condi- tions which e...xisted in the uterus, as in Figs. 372, 373, 374. An ovum may be expelled naked, as in Fig. 375, or covered Decidua vera Fig. 377. — Incomplete Abortion — Three Months.
When the fetus only is expelled, all the secundines re- main in the uterus.
Fig. 37S. — Placenta. Protruding Polypoid into Vagina and Partly Attached, Inviting Sepsis. Thick De- cidua still in Uterus.
with portions of the decidua. Whenever the ovum alone, covered by the shaggy coat of villi, is expelled, one must conclude that the decidual still remain in the uterus, and will require another effort of nature, which is often attended by pro- fuse hemorrhage.


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