Identifier: manualofantenata01ball (find matches)
Title: Manual of antenatal pathology and hygiene : the foetus
Year: 1902 (1900s)
Authors: Ballantyne, J. W. (John William), 1861-1923
Subjects: Fetus Prenatal care Fetus Prenatal Care
Publisher: New York : William Wood
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons

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iginating in the foetus apart from maternalstates. These may yet be traced to diseased states of the mother,but this stage in our knowledge has not yet been attained. In considering the pathology and imtliogcnesis of the malady, onenaturally thinks first of hepatic lesions and disturbance of the portalsystem; but it has already been stated that morbid alterations of theliver in such cases have been very rarely noticed. It would seemthat ascites due to causes in the portal system is not, therefore,common in the fa3tus, a state of matters not so difficult to understand,if it be remembered that this part of the vascular system is thencomparatively inactive on account of the quiescent condition of the FCETAL ASCITES 161 gastro-iiitestinal caual. In Hermans case, however, the cause seemsto have been pressure on the portal vein by a large tumour of theright supra-renal capsule (Mccl. Times and G-az., ii. 731, 1881). But,with few exceptions, the ascites seems to have been due to peritonitis,
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a conclusion which appears to be warranted by the morbid anatomyof most of the specimens. What the cause of the peritonitis mayhave been is not well known, but in one case (Olshausens, loc. cit.) itwas the escape of urine into the peritoneal cavity. In Fordycesspecimen (loc. cit.) the peritoneum had lost its normal endothelialcovering, and great thickening of the subendothelial connective tissue 362 ANTENATAL PATHOLOGY AND HYGIENE had taken place, with degeneration of some of its superficial layers(Fig. 53). Hardouin and Moreau (Rev. obstSt. internat., suppl., i. 184,1895) report a case in which the foetus exhibited ascites, hydro-thorax, slight hydropericardium, along with cleft palate and cardiacmalformations; the authors regarded the ascites as due, in this case,to the anomaly of the heart (absence of complete interventricularseptum). It is necessary, then, to keep in mind that fatal ascites,like general fcetal dropsy, may be due to several causal factors; atthe same time Porak and

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