Ectopic pregnancy; its etiology, classification, embryology, diagnosis and treatment.

  • John Clarence Webster
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Ectopic pregnancy; its etiology, classification, embryology, diagnosis and treatment. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

    235/384 (page 215)
    I. When the gestation is entirely tuhcd, no rupture having occurred either into the hroad ligament or ])eritoneal cavity. (a.) Ampullar and Infundibular. When, the gestation is diagnosed, the patient and her friends should be informed of the seriousness of her condition. She should take great care of herself while her case may be under consideration, avoiding every form of exertion which might, by producing sudden strain, bring about a rupture of the gestation sac. The only form of treatment to be recommended is abdominal section, which should be carried out under the conditions now so well recognised as essential to success. In the early months the operation consists in removing the entire tube by the ordinary method. The broad ligament is ligatured below the tube, either by the Staffordshire knot or by interlacing sutures. The ovary is usually removed along with the tube. The first case in which a tubal gestation was successfully diagnosed and removed by laparotomy was reported by Veit ^ in 1885. The operation is, when uncomplicated, a very simple one. Difficulty may arise from the following causes :— The tube may be adherent to surrounding parts. G-reat care must be used in separating the adhesions, which are treated in the ordinary manner, lest rupture of the sac should occur. Some gestation sacs are so matted down by adhesions that they cannot be raised up, so as to allow of the easy passage of ligatures below. In such a case, it is best to ligature the broad ligament and tube internal to the swelling by a series of sutures passed from above downwards. The sac may then 1 Ztschr.f. Geburtsh. n.. GyndL, Stuttgart, 1SS5, bd. xi., p. 3S4.