Silvio Aladjem

Observation of an organism found in patients with gestational trophoblastic disease and in patients with toxemia of pregnancy

Abstract This is an initial descriptive report of observations of multiple forms of an organism found in patients with gestational trophoblastic disease and in patients with preeclampsia-eclampsia. The worm-like forms most frequently observed have an average length of 1.0 to 1.5 mm. Larva-like forms have an average length of 150 μ; primordial eggs and egg-like forms in developmental stages range from 7 to 43 μ in diameter; and sperm-like forms are 3.5 μ or slightly smaller in size. These forms have been observed in contact smears prepared from 3 ml samples of peripheral circulating blood from both groups of patients, from trophoblastic tumor tissue, from contact smears prepared from placentas of patients with preeclampsia-eclampsia, and from umbilical cord blood of infants delivered of patients with preeclampsia-eclampsia. The various forms of this organism share morphologic characteristics of several orders of helminths, i.e., hookworms, roundworms and tapeworms. The taxonomy of these forms has not yet been determined. Until the time of taxonomic classification, the various forms will be referred to as Hydatoxi lualba . We have experimental evidence that this organism has biologic activity in BALB/c mice and in beagle dogs.

Morphologic aspects of the placenta in gestational diabetes seen by phase-contrast microscopy

A study of 54 placentas from patients with gestational diabetes as determined by a rapid intravenous glucose tolerance test was carried out by phase-contrast microscopy and compared with 65 placentas from normal uncomplicated pregnancies. There were no gross pathologic abnormalities in either group. Microscopically, the type of placental pathology was found to be more important than the presence of indiscriminate pathology. The pathology of the placenta was found to include: (a) detachment, rupture, or disappearance of the syncytium; subsyncytial edema and hyperplasia of the syncytium (syncytial pathology alone); (b) edema and intravillous hemorrhage (stromal pathology alone) ; and (c) mixed syncytial and stromal pathology. The mixed syncytial and stromal pathology or stromal pathology alone with severe edema and intravillous hemorrhage was associated with the poorest fetal outcome. All neonatal complications and perinatal deaths occurred with variants of this type of pathology. Syncytial pathology alone did not appear to adversely affect the infant. Although the pathology of the placenta in gestational diabetes is not specific, it may provide a method of establishing a postnatal prognosis for the infant which cannot be anticipated otherwise.

Perinatal evaluation and prognosis of the premature fetus and newborn infant through phase-contrast microscopy of the placenta

Abstract 1. 1. Forty-six placentas of premature infants were studied with a phase-contrast microscope. 2. 2. Placentas were divided into three types: normal as per gestational age, termlike, and pathologic. The infant outcome was related to these three groups. 3. 3. The pathology of the placenta appears to be a more reliable approach when judging a premature prognosis, since 100 per cent of the perinatal mortality was reflected in some pathologic finding in the placenta, while there was no mortality in the first two placental types, regardless of gestational age or birth weight. 4. 4. A different concept of “fetal maturity” is suggested, which does not rely on weight at birth or gestational age. 5. 5. Placental biopsy offers an excellent and innocuous method of evaluating the premature fetus in utero.