The surgery of pregnancy and labour complicated with tumours / by J. Bland-Sutton.

  • Sir John Bland-Sutton, 1st Baronet
Date:
1901
Catalogue details

Licence: In copyright

Credit: The surgery of pregnancy and labour complicated with tumours / by J. Bland-Sutton. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    into a large, soft, tooth-bearing dernioid, which had twisted its pedicle through two complete revolutions,‘and lay between the uterus and bladder. The uterus was about six weeks gravid, and the right ovary contained a large corpus luteum. The dermoid was removed, and the patient recovered without any disturbance of her preg- nancy. This patient had conceived subsequent to the axial rotation of a large ovarian dermoid, and whilst the tumour, with its twisted pedicle, encumbered the pelvis. It may not be amiss if I briefly draw your attention to the steps by which the surgical treatment of ovarian tumours complicating pregnancy has been evolved. Al- though ovariotomy during pregnancy had been success- fnlly performed in 1847 by Burd of Shrewsbury, by W. L. Atlee in 1850, and by Marion Sims, the procedure did not meet with favour until Spencer Wells forced it on the pro- fession in 1877. This surgeon had pointed out its justi- fiability in 1870; but seven j^ears later he strengthened his argument by reporting nine cases of ovariotomy during pregnancy with one death. The discussion which followed the reading of his paper at the Obstetrical Society of London is well worth perusal, as indicating the opinions regarding this grave complication and its treatment, held by the leading obstetricians of that period. A very large number of cases have since been recorded which show that it is now the recognised method of treatment in the early stages of pregnancy. It would be suspected that the risks of ovariotomj' during pregnancy would be those of an ordinarj* ovario- tomy, jjIus the chance of abortion with its ordinary dan- gers ; but an analysis of a large number of cases demon- strates that when ovariotomy is performed before the fourth month of pregnancy the chances of abortion are very small, whereas the average mortality is less than in ovariotomy performed on non-gravid women. The risks of even double ovariotomy during pregnancy, when the opei-ation is undertaken before the fourth month, are very small, and the chances of disturbing the ])regnancy are