In a medieval population of Stockholm only three cases of maternal deaths were proved out of 330 burials of adult females, and only in one of the cases was a contracted pelvis found. However, life table analysis indicates a shorter life expectancy of females in the reproductive ages. This suggests a higher maternal mortality in the Middle Ages than in the 18th and 19th centuries in Sweden.

The frequency of venous thromboembolism is high in geriatric practicel-3, particularly among surgical geriatric patients .4, Pulmonary embolism is a major (in some series the most common) cause of death in the elderly. 4, 6 In spite of abundant information concerning venous thromboembolism, there are still many unsolved questions from pathogenetic and diagnostic, as well as therapeutic points of view.Although clinical diagnostic procedures, in particular the use of phlebography,7-14 have been of great importance for the elucidation of the frequency and extent of thromboembolic disease, autopsy studies are a necessary complement for detailed information in this respect. Such studies must include, besides a thorough investigation of the pulmonary arterial system with its smallest ramifications, a complete venous dissection of the lower extremities. However, extended dissections of this kind are cumbersome and time-consuming, and are associated with such great practical inconveniences that they have been performed thoroughly only by a few investigators. 4, 15In order to facilitate the pathoanatomical exploration of the veins of the lower leg for broad postmortem studies of the frequency and significance of venous thromboembolism, intraosseous phlebography has been adopted as a new procedure for postmortem purposes at the Stureby Vardhem Geriatric Unit. This method, first described by Drassner,16 has previously been applied in extensive clinical studies, particularly by Arnoldi and Bauer.lo~ ~1The aim of this communication is to describe the method for intraosseous postmortem phlebography and to present preliminary data from studies in which this method has been utilized for examinaton of frequency and localization of thrombosis in the legs in geriatric patients. A more comprehensive and extended analysis of the material will be published later.l7Studies based on autopsy data from a general hospital fail to reflect the incidence of terminal illness in the community if admission of aged people is restricted and the autopsy frequency is low.2 Custodial institutions, on the other hand, provide unique access to information regarding the general incidence of such diseases. The

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In postmortem exploration of the veins of the lower limbs for studies of the frequency and significance of thromboembolism intraosseous venography with injection of contrast medium into the calcaneus was performed followed by complete dissection of the leg veins. A good agreement was found between venographic results and dissection findings. Out of the 596 legs examined, deep venous thrombosis was found in 229 (38%). In 32 of the lower limbs (5.4%) a definite localization and adherence of thrombi to valve pockets was noted. Altogether, 37 such thrombi were encountered. In addition 9 small thrombi of early type were found floating freely in the venous lumen just above a pocket. Microscopically the thrombi showed the greatest degree of organization at the bottom of the valve pocket speaking for this localization as the origin of formation. This is in accordance with the fact that stasis of blood would be most pronounced at the bottom of valve pockets as shown by retention of contrast medium in pockets in clinical venography. In a clinical series of venographies performed after hip surgery several thrombi located to valve pockets were found. Some of these thrombi had proximally free floating tails forming a potential menace of fatal pulmonary embolism.