Fetus

“ Nor is this unanalogous to what still occurs, as all quadrupeds and mankind in their embryon state are aquatic animals; and thus may be said to resemble gnats and frogs. The fetus in the uterus has an organ called the placenta, the fine extremities of the vessels of which permeate the arteries of the uterus, and the blood of the fetus becomes thus oxygenated from the passing stream of the maternal arterial blood; exactly as is done by the gills of fish from the stream of water, which they occasion to pass through them. ”

“ There may be an abortion, when the fetus and membranes are partly or completely extruded from the fimbriated end of the tube into the peritoneal cavity; or a rupture of the tube, when the fetus, with or without the membranes, may be expelled into the peritoneal cavity, or between the folds of the broad ligament. If the greater part of the placenta remains attached to the site of its development, in the case of a ruptured tube, it is possible for the fetus to live and grow and even go to term. ”

“ GROWTH AND PHYSIOLOGY OF THE FETUS Although the fetus at term is in many respects simply a diminutive, immature man, or woman, its anatomy and physiology present certain characteristics which have adapted it to a protected existence in a sac of fluid. Some of the fetal structures and functions become increasingly active after birth, while others subside and disappear. ”

“ We have seen that after the first month of pregnancy the placenta serves the fetus as a combined respiratory and digestive apparatus, not alone in supplying the oxygen and nourishment requisite for life and growth, but also in excreting the broken-down products of fetal life. ”

“ The life of the fetus, therefore, is absolutely contingent upon an uninterrupted, two-way flow of blood through the cord.
The Fetus. In tracing the development of the ovum after its implantation in the uterine lining, we begin, as previously stated, with a shaggy-looking vesicle, containing fluid, with a clump of cells hanging toward the centre from their point of attachment on the inner surface of the sac. This clump develops into the embryo. ”

“ It also affords the fetus greater freedom of motion, and protects the womb and other parts from injuries which might otherwise be inflicted by the fetus after quickening. Within this fluid the fetus floats during its formative period, and when the time of birth comes the breaking of the sac which contains this fluid enables it to flow out, lubricating the parts, or channel, through which the newly formed being is to pass in its exit into the outer world. ”

“ An incomplete abortion is one in which the fetus is expelled but the placenta and membranes remain in the uterine cavity. The treatment is removal of the retained tissues, followed by the same care that is given during the normal puerperium. Prompt action in completing the delivery is important because of the hemorrhage that usually persists until the uterus is entirely emptied of its contents. ”

“ The uterus also becomes softer in tubal pregnancy, and the cervix softens somewhat, though not so much as in a uterine pregnancy.
If the woman and the fetus survive the many dangers that accompany the progress of tubal gestation, the development of the fetus will go on to full term, and then the phenomenon of spurious labor will come on. ”

“ The danger to the mother is from hemorrhage before the expulsion of the embryo, and from retention of membranes after the fetus is born. These decaying in the uterus, the poison is absorbed into the system and septicæmia is the result.
The causes of abortion, both remote and exciting, [Pg 244] are numerous. Any diseases of the womb that take away its vitality or prevent its enlargement will result in death of the fetus. Any general disease or condition of the system that results in weakness or feebleness may make the continuance of life in the embryo impossible. ”

“ After the placenta and the sacs which enclosed the fetus, which together constitute what is known as "the afterbirth," have passed away, the recuperating and renewing powers with which God has so wonderfully endowed the body of the mother beyond that of the father become active. ”

“ Granted that it remains fixed, woe to the woman if she becomes pregnant. The womb cannot assume the constantly changing positions of pregnancy, and the result is either abortion or malformation of the fetus, together with great and constant suffering to the woman. ”

“ A new human being is the ultimate result of conception, but the chorion, amnion, placenta and umbilical cord must also be created to serve as aids in building and protecting the developing child during its uterine life. The part played by these accessory structures is so vital, in spite of being temporary, that it will be well for us to look into their origin and functions before considering the fetus itself which they serve. ”

“ It is also well to know that if a discharge exist at the epoch of conception, the fetus is more or less diseased, and in this case a man must abstain from all connection, and the woman should resist sexual advances, if she have foresight. ”

“ Among other causes of abortion must be named the death or the various illnesses of the fetus, which are about as numerous as those of the adult; the slipping of a young fetus through a loop in the navel string so as to tie a knot which will tighten later and interrupt the flow of blood with fatal effect, and the twisting of the navel string by the turning of the fetus until little or no blood can flow through the contorted cord. ”

“ Although the exact length of time required for the maturation of the fetus is not known, it is estimated that two hundred and eighty days, or ten lunar months, elapse between the beginning of the last menstrual period and the beginning of labor. And in spite of the difference in size among the mothers, it is found that the products of conception develop and grow at a fairly uniform rate of speed. ”

“ He managed to push the obstructing body up and delivered a living, full-term child; this was soon followed by a blighted fetus, which was 11 inches long, weighed 12 ounces, with a placenta attached weighing 6 1/2 ounces. It is quite common for a blighted fetus to be retained and expelled at term with a living child, its twin. ”

“ When the placenta is examined, it is found that certain changes have taken place in its structure which interfere with the circulation of the blood through the placenta, and may indirectly bring about the death of the fetus. The child is also subject to the same toxic conditions which the mother has had and may die from failure of the liver and kidneys or in convalescence. ”

“ Abortions during the later stages of pregnancy are attended with greater constitutional disturbance, and the process resembles normal parturition, with the aggravation that more effort and straining is requisite to force the fetus through the comparatively undilatable mouth of the womb. ”

“ At the same time, the viability standard takes account of the undeniable fact that, as the fetus evolves into its postnatal form, and as it loses its dependence on the uterine environment, the State's interest in the fetus' potential human life, and in fostering a regard for human life in general, becomes compelling. ”

“ Obviously, then, the fetus must possess a circulatory mechanism which is peculiar to itself alone, and not found in the independently existing human body, in which the lungs and alimentary tract are functioning as intended. ”

“ The child made an early recovery. Rogers mentions a fetus that was found in a man's bladder. Bouchacourt reports the successful extirpation of the remains of a fetus from the rectum of a child of six. Miner describes a successful excision of a congenital gestation.
Modern literature is full of examples, and nearly every one of the foregoing instances could be paralleled from other sources. ”

“ Occasionally water may form between the three membranes, and during labor the chorion may rupture [Pg 174] and not the amnion, and the waters between them be discharged. In like manner, water which has formed between the decidua and the chorion may come away. These, then, are two sources of fluid which may be discharged from the vagina in labor when the amnion is intact.
Umbilical Cord.—The organ by which the fetus is attached to the uterus is a whitish, glistening structure which springs from the fetus at the center of the abdomen, and passes to the internal aspect of the placenta. ”

“ It must be evident to the plainest understanding, that serious injury to the health of both mother and child must often result from a continued and forcible compression of the abdomen, while nature is at work in gradually enlarging it for the accommodation and development of the fetus. ”

“ Marcellus Donatus, Goret, Schacher, and Mauriceau mention superfetation. In the Academie des Sciences, at Paris, in 1702, there was mentioned the case of a woman who was delivered of a boy; in the placenta was discovered a sort of bladder which was found to contain a female fetus of the age of from four to five months; and in 1729, before the same society, there was an instance in which two fetuses were born a day apart, one aged forty days and the other at full term. ”

“ On the seventh of August, 1827, he read a paper on extrauterine pregnancy, in which he seemed anxious to establish the opinion, from the historical detail of cases, that ventral or abdominal pregnancy never originally occurred; that tubal or uterine pregnancy had previously existed in cases where the child was found in the cavity of the abdomen, the tube or uterus having been ruptured or ulcerated so as to allow the escape of the fetus from its original location into the peritoneal cavity. ”

“ And all this only comes to prove it's permitted by its mother's shechita, like other fetuses found in it. But if that beast then gives birth, also that limb that was emerged and retracted is permitted, as its own shechita permits everything. ”

“ A TEXT BOOK OF OBSTETRICS. Barton Cooke Hirst, M.D., Professor of Obstetrics in the University of Penn.; Gynecologist to the Howard, the Orthopaedic and the Phil. Hospitals, etc. 7th Edition. W. B. Saunders Co., Phil, and London, 1912.
The effect of chronic diseases of the mother upon the fetus. Women affected with tuberculosis, cancer, or chronic malarial poisons may give birth to a succession of dead children. ”

“ But canst thou only die, withered embryo, fetus steeped in gall and scalding tears? Miserable abortion, dost thou think thou canst taste death, thou who hast never known life? If only God exists, that he may damn me. I hope for it—I wish it. God, I hate Thee—dost Thou hear? Overwhelm me with Thy damnation. To compel Thee to, I spit in Thy face. I must find an eternal hell, to exhaust the eternity of rage which consumes me.” ”

“ The nausea, which pregnant women are so subject to during the first part of gestation, is owing to the reverse sympathy between the uterus and stomach, so that the increased action of the former, excited by the stimulus of the growing embryon, which I believe is sometimes attended with sensation, produces decreased actions of the latter with the disagreeable sensation of sickness with indigestion and consequent acidity. When the fetus acquires so much muscular power as to move its limbs, or to turn itself, which is called quickening, this sickness of pregnancy generally ceases. ”

“ The due term of labor is past and as a consequence fetuses grow too large within the uterus, greatly increasing the difficulties of parturition and adding to the risk of both mother and child. It is the custom to announce with pride the birth of twelve- and fifteen-pound babies, but it is doubtful whether nature intended that growth to this extent should take place before birth. ”

“ When pains follow the expulsion of the first child, there is every reason to believe that they will in proper time accomplish the birth of the second, because it will receive the whole influence of the expulsive efforts of the uterus, whereas before it was expended upon both fetuses, and because the subsequent pains will be more powerful, since the uterus is now smaller, and its contractions consequently more perfect ”

“ The comparative growth of the fœtus infinitely surpasses that of its whole future existence. But the exact age of uterine embryos, and of abortives, is, in some degree, conjectural. Before the seventeenth day after conception, its rudiments are not even visible to the naked eye: the glary ovum has then slidden down from the ovarium, through one of the lateral tubes into the womb. The size of an abortion, comprehending the fœtus, its membranes, waters, and placenta, at the end of six weeks, does not exceed in size that of a pigeon’s or hen’s, and in three months, a goose’s egg. ”

“ That the embryo probably lives in utero in virtue of its own life-principle, even through the entire period of gestation, (51, 56, and 58,) is rendered probable by many facts related by unimpeached authorities, which go to prove that when the whole intact Ovum has been expelled at an advanced period of gestation, or at the natural termination of that period, the fœtus has continued to live, and the circulation of the blood has not ceased for an instant during a space of time of from nine minutes to a quarter of an hour. ”

“ Normal Course.—We have already delineated the normal course of abortion at this period. The death of the embryo has usually preceded, often for weeks, and is characterized by the feeling of pelvic congestion, gastric and vesical irritation, weariness, weakness, and increase of uterine and vaginal secretion; the membranes have developed more or less; expulsion is inaugurated by hemorrhage. If the cause be more violent, the flow of blood is free. Usually there is but a slight oozing, which ceases at times, but gradually increases; the suffering which accompanies uterine contraction is present. ”