A system of midwifery / by Edward Rigby.

  • Edward Rigby
Date:
1844
Catalogue details

Licence: Public Domain Mark

Credit: A system of midwifery / by Edward Rigby. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    here developed ; it may pass into the Fallopian tube arid remain there ; or from some defect in the action of the fimbriated extremity of this canal, it may escape into the cavity of the abdomen, and become attached to some of the viscera. Hence extra-uterine pregnancy has been divided into three s\)ecies,viz.graviditas tubaria, ovaria, and ventralis, according to the situation which the ovum takes. A fourth has been also described by M. Breschet, which he has called graviditas in substantia uteri, a modification probably of tubarian pregnancy. a The uterus, its cavity laid open, b Its parietes thickened, as in natural pregnancy. c A portion of decidua separated from its inner surface, d Bristles to show the direc- tion of the Fallopian tubes, e Right Fallopian tube distended into a sac which has burst, containing the extra-uterine ovum. / The foetus, g The chorion. h The ovaries ; in the right one is a well marked corpus luteum. i The round ligament. This singular deviation from the usual course of conception is fortunately of rare occurrence, for few cases terminate favourably. If it be in the Fallopian tube or ovary, these become immensely distended into a species of sac or cyst, to the sides of which the placenta adheres : as the ovum increases, this at length gives way from excessive distension, and the patient usually dies from internal haemorrhage. In ventral pregnancy, the sac is attached to the abdominal vis- cera, and is usually imbedded among the convolutions of the intestines : hence the duration of extra-uterine pregnancy will depend upon its situation : thus, if it be in the Fallopian tube, it rarely lasts beyond two months ; whereas ovarian pregnancy will continue for five or six months ; on the other hand, in ventral pregnancy the foetus will not only be carried to the full term, but far beyond that period, amounting to several years.* Although the uterus does not receive the ovum into its cavity as it does in natural conception, it nevertheless undergoes many of those changes which are known to take place in regular pregnancy. The layer of coagulable lymph, which is effused upon its internal surface, and which forms the membrana de- cidua of Hunter, is present, and the uterus undergoes a slight increase of volume. As the ovum increases, excruciating pains are felt in the lower part of the ab- domen, coming on at irregular intervals, and of irregular duration; in some cases lasting for a short time, in others continuing for twenty-four hours. These * Our friend Dr. Nebel of Heidelberg has a preparation of a foetus which was retained for fifty-four years in the abdomen. This is the longest period on record of a foetus being retained in the cyst of a ventral pregnancy. Many other cases have been described- (See Burns, 9th edition, where the notes contain very ample references.) . F 4
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