CHAPTER VII.

THE OVUM AND ITS DEVELOPMENT.

The ovum at maturity (and not impregnated) is described as being

composed of the vitelline membrane, which seems like albumen in

appearance, but is a thick, transparent membrane, without determinate

texture; second of the vitellus or yolk, a granular liquid contained in

the vitelline membrane, composed of a coherent transparent viscid mass;

third of the germinal vesicle, which is composed of a transparent

colorless membrane, enclosing a liquid also transparent; and lastly, of

the germinal spot, that is held in suspension in the liquid that the

germinal vesicle contains.

The ovum passes slowly through the Fallopian tubes, and during the

twelve days or more that it is passing to the uterus, there is some

development, some increase in size, and by the time it has reached the

uterus it has become impossible to find in it either vesicle or germinal

spot.

It is probable that in its passage it is nourished by the granulations

which accompany it, and by absorbing the liquid secreted by the oviduct.

As the impregnated ovum is developed, the chorion, the amnion and the

embryo may be observed.

The _chorion_, which corresponds to the membrane lining in the shell of

an egg, is found covering the ovum at the earliest period that it has

been seen in the uterus. It is smooth internally, but externally it is

covered with short round villi, which at a later period remain only

where the placenta is developed. The chorion is enveloped in a great

measure by the reflected decidua; there is at the outset considerable

space between the two, mostly filled at first by the villi of the

chorion, though there may be between the two an effusion of blood; these

villi soon disappear, and the membranes come in contact.

In that part of the chorion that is not covered by the decidua reflexa,

the villi are more and more developed, and they contribute a most

important part in the formation of the placenta.

At the same time that the placenta is formed, the villi on the other

portion of the chorion is obliterated, so that the principal part of the

chorion is a thin, colorless, transparent membrane, united outwardly to

the reflexed decidua by short, delicate filaments, and inwardly to the

amnion by an albuminous layer called the _tunica media_.

There is also between the two membranes the _vesicula alba_. This bears

a perfect analogy to the yolk of an egg; it is the vitellus surrounded

by the blastoderm. Its use is to contain nutriment for the fœtus before

the development of the placenta.

The amnion is the most internal membrane of the ovum; it is continuous

with the margins of the ventral opening in the fœtus, and closely

envelopes the embryo in the early period. Its internal surface exhales a

liquid into its own internal cavity, and in this the embryo swims

freely.

As this membrane is more and more filled, it presses back the exterior

liquid and thereby condenses it until the amnion comes in contact with

the chorion. And since it adheres to the abdominal parietes of the

fœtus, it furnishes as it extends a membranous sheath to the allantoid

and umbilical vesicle, and these vessels, and all parts thus enclosed

constitute the _umbilical_ cord.

The _placenta_ is an appendage of the chorion; it is a soft, spongy

mass, constituting the principal connection between the ovum and the

uterus, being destined to the hematosis and (as we suppose) to the

nourishment of the fœtus. The placenta, at the termination of utero

gestation, is a flattened body about an inch in thickness at the center;

its shape is circular or oval, and it is from six to eight and one-half

inches in diameter; its internal surface is covered by the chorion and

amnion, and exhibits plainly the umbilical arteries and veins which

converge to form the umbilical cord. Its fœtal portion is formed by the

hypertrophied villi of the chorion, with which its circumference is

continuous, and its maternal portion is continuous with the decidua, and

is in fact a thickened part of that membrane. As the villi of the

chorion are developed on one part of its surface, they ramify and form

filaments that engraft themselves upon the uterine mucous membrane and

adhere closely. At the same time there is an inverse development of the

uterine vessels, which form vast numbers of loops that descend between

the villi of the chorion, and extend through to the fœtal surface of the

placenta. An amorphous matter is soon thrown out which unites the two

parts together.

The placenta is, therefore, composed of two parts, distinct in their

physiological action, though they together present but one mass to our

view. One part is the fœtal portion formed from the chorion; the other

is the maternal portion formed from the uterine mucous membrane, of

which it is a greatly thickened part. After delivery the fœtal placenta

comes entirely away with the epithelial layer of the placental decidua,

and the placental distribution of the maternal vessels; a portion of the

maternal vessels remains attached to the uterus.

The placenta may be inserted upon any part of the uterine cavity,

although it is most usually near the fundus where the ovum must enter

the womb. If, as is sometimes the case, it is attached at the lower

part, over the orifice of the womb, it causes unavoidable hemorrhage in

the later months of pregnancy.

The _umbilical cord, funis, or naval string_, is the connecting link

between the child and mother. It commences when the external lamina of

the blastoderm with the alantois are so changed as to form a mere cord

upon which the two umbilical arteries ramify, and when all these have an

enveloping sheath from the amnios. It may be discerned in this state at

the end of the first month; at that time the fœtal intestines may be

seen to protrude beyond the umbilicus into the amnionic sheath, but the

cord is then cylindrical and very small. There are progressive changes,

the cord becomes simplified, the canal of the amnionic sheath is

obliterated gradually at its extremity, and as the effacement proceeds

towards the umbilicus the intestine is pressed back so that no hernia

remains.

There are two arteries in the cord; these arise from the abdominal aorta

in the fœtus; they go by a flexed and tortuous course to the placenta,

where they ramify and are distributed. There is only one vein which

returns the blood from the placenta; there the radicles coalesce to form

the branches; these unite to form the umbilical vein. This is not as

flexuous as the arteries, which, being longer, wind around the one

venous trunk. After the third month these may be plainly seen in the

sheath imbedded in what has been called _Wharton’s gellatine_.

Ordinarily the cord lies free and loose in the cavity of the amnion, but

occasionally owing to the movements of the child it may be coiled around

the child’s neck, be tied in knots, or it may escape below the head so

as to prolapse during labor.

The length of the cord varies; it is very rarely less than eight inches,

and it is sometimes six or eight feet long.

After the birth of the child, the pulsation in the cord ceases within

about fifteen minutes. After the cord is cut that portion that is

attached to the umbilicus dies and usually falls off about the fifth

day.

The blood of the fœtus is ærated or undergoes a change in the placenta

analagous to the change that our blood undergoes in the lungs.

Mother, Nurse and Infant A Manual Especially Adapted for the Guidance of Mothers and Monthly Nurses, Comprising Full Instruction in Regard To Pregnancy, Preparation for Child-birth, and the Care of Mother and Child, and Designed to Impart so Much Knowledge of Anatomy, Physiology, Midwifery, and the Proper Use of Medicines as Will Serve Intelligently to Direct the Wife, Mother and Nurse in All Emergencies. · 第 7 / 11 章