Repeated pregnancy in the same tube: a case of homotopic and homositic repeated tubal pregnancy.

  • Stahl, Frank August, 1862-1936.
Date:
1901
Catalogue details

Licence: Public Domain Mark

Credit: Repeated pregnancy in the same tube: a case of homotopic and homositic repeated tubal pregnancy. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    History.—Bix years ago Mrs. K. S., aged 33, noticed a grad- ually increasing, movable, firm tumor in the abdomen. Men- struation had ceased six months; during this time the tumor increased in size; patient thought herself pregnant. Since re- turn of menses the tumor decreased in size until in the autumn of 1896, by which time the tumor had declined to the size of a fist. In the early part of 1897 the tumor commenced to grow again; in April she felt movements therein, which ceased in Au- gust, since which time she reports a decline in the size of the abd.omen. In ]\Iay, edema of face and feet. Since June she com- plains of a severe cough (tubercular) and loss of strength. When entering Helsingfors Clinic, September, 1897, the diag- nosis could not be fixed with any certainty. The history sug- gested a retained dead intrauterine fetus, though repeated exam- ination failed to find fetal parts; aside from the history a large fibroid was suggested. A smooth, firm tumor could be felt in abdomen, extending from symphysis to midway between umbili- cus and xiphoid process and laterally to a finger's breadth of the anterior, superior spinous processes. During the repeated examinations undertaken no fetal parts were to be felt, likewise no sounds audible. No light from the use of the Eoentgen rays. Diagnosis in suspensio. October 10, cer^dx dilated mth lami- naria tent and Hegar 's sounds to touch with finger; could find no fetal parts. October 13, peritonitis; October 16, exitus lethalis. At the postmortem, opening the tumor (from the left tube) a well-developed fetus of 51 centimetres was found; macroscopical- ly no maceration. Cutting into a boggy second mass alongside the mature fetus, there were found fetal bones and bone frag- ments, considered remnants of a previous pregnancy. Case IV.—History of my case. It is fulsome, yet interesting. Aside from the pregnancies and operations, it shows to what traumatic extremes a gjniecean pelvis may be exposed and still a-ecover. I\Irs. X., 5 feet 4 inches in height, weight 125 pounds, now 28 years of age; physically normal. Childhood and family his- tory without pathological importance. First menstruated at 14 years; three to five days, always regular and painless. Course of first pregnancy normal; normal in position; normal delivery by midmfe of eight-pound boy November 21, 1893; second stage two hours; third stage half an hour. Puerperium such that she arose on the seventh day, but from then on to when I first saw her, in July, 1897, there is a history of a pelveo-para-perimetritis.