Reproductive Physiology of the Post-partum Period

THE title of this monograph is too broad for its limited though valuable approach. The approach is that of morbid anatomy and clinical observation and the term "physiology" is justified only since it is an attempt to define the normal changes of the post-partum period. Essentially these studies are limited to a histological study of the endometrium from soon after delivery till nine months thereafter; the re-establishment of ovulation as indicated by the appearance of the secretory phase of the endometrial cycle and the date of re-appearance of menstruation and its subsequent rhythm. The basis of the work is 626 endometrial biopsies from 285 women from the fifth day to nine months after parturition and all free from puerperal infection. Of these women 230 had one biopsy only. The remainder had from 2 to 24 biopsies and in these the normality of the later biopsies might be questioned. However the author has an extensive series of biopsies, which he seems to have carefully correlated, and which enables him to describe regeneration of the endometrium following childbirth. Cellular reaction as indicated by the presence of plasma cells is described as late as the third and fourth months in over one-third of the cases. The earliest appearance of secretory endometrial patterns, taken as presumptive evidence of ovulation, was noted during the seventh week. This is a useful study presented in detail and with an over abundance of microphotographs, many of which show little distinctive change. It would seem that the work in a shortened but unimpaired form might have graced a learned journal. Elegantly presented and beautifully printed and bound as, indeed, one expects from the publishers, it is moderately priced and should be included in the library of all interested departments. J.E.M.