Bilharziasis of the pregnant uterus.

SCHISTOSOMIASIS (bilharziasis) is a parasitic infestation which may affect a host of body organs but whose brunt usually falls on the urinary or the intestinal tracts. Even in localities where the disease is endemic such as Egypt, South and East Africa, South America and Japan, involvement of the female genital organs is comparatively rare. Few papers dealing with gynaecological bilharziasis have appeared in the literature, and in some of them the effect of the disease on the female reproductive function was briefly discussed. Charlewood, Shippel and Renton (1949) described a case of post-partum uterine fibrosis in a woman who suffered from vesical bilharziasis and thought that the fibrosis of the uterus might have been of bilharzial origin but they could find no bilharzia ova in the uterus or in any other part of the genital tract. Narabayashi (1914) reported a unique case in which the worm of Schistosoma japonicum passed through the placenta and infested the foetus. Bilharzial infestation of the pregnant uterus, however, has never before been demonstrated. We have lately been removing small pieces of tissue from the cervix and the upper and lower segments of the pregnant uterus in order to investigate the arrangement of the muscle and connective tissue fibres. In two of the cases studied bilharzia ova were accidentally encountered in the wall of the pregnant uterus.