Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating itBurns, John
Science
Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating it
Burns, John
Miscarriage
This, when gestation goes on regularly, is accomplished gradually and
slowly by the extension and formation of fibres. In abortion, no fibres
are formed; but muscular action does all, except in those instances
where the action of gestation goes on irregularly and too fast; in which
case the cervix distends, sometimes by the third month, by the same
process which distends the fundus. But much more frequently the cervix
only relaxes during abortion, as the os uteri does in natural labour,
and yields to the muscular action of the fundus, or distended part.
The existence and growth of the fœtus depends on the fœtal portion of
the ovum. The means of nourishment, and the accommodation of the fœtus
in respect of lodgement, depend on the uterus; and these circumstances
requiring both fœtal and maternal action, are intimately connected. The
condition of the uterus qualifying it to enlarge, to continue the
existence and operation of the maternal portion of the placenta or ovum,
and to transmit blood to the ovum, exactly in the degree correspondent
to its wants, constitutes the action of gestation.
When this condition ceases, then muscular contraction begins, provided
the cessation be universal in the uterus. This is necessary, for as the
fœtal and maternal actions are dependent on each other, the fœtus would
suffer if it were not expelled. The injury, indeed, will not be
immediate; otherwise, in labour, the child would die before it could be
born, because labour implies a cessation of the action of gestation. On
the other hand, the loss of action in the fœtal part will soon influence
the maternal part, and stop its action.
In labour, and at other times, when the action of gestation ceases, the
circulation is still kept up in the maternal vessels of the placenta,
until either separation and expulsion take place, or the vessels suffer
so much as to cease to transmit blood. The cessation of action then does
not necessarily immediately affect the fœtus. As long as it, and the
fœtal portion of the ovum connected with it, remain stationary, the same
quantity of blood will do. But the uterus cannot now increase its
actions along with those of the fœtus, so as gradually to enlarge and
send more blood.
This is one cause of disagreement. Another is, that, in consequence of
cessation of action in the uterus, the maternal portion of the placenta
or ovum ultimately suffers, and flags or decays, whilst the fœtal
portion must sympathize with it.
From this it results, first, that even in tedious labour the child does
not die: secondly, that when the action ceases in the early months of
pregnancy, the fœtus does not instantly die, nor abortion immediately
take place: thirdly, but it invariably happens, that, at whatever period
the action ceases, the fœtus will, if not expelled within a certain
time, perish.
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