Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D.
- Lawson Tait
- Date:
- 1888
Licence: Public Domain Mark
Credit: Lectures on ectopic pregnancy and pelvic haematocele / by Lawson Tait, F.R.C.S., Edin., & Eng., LL.D. Source: Wellcome Collection.
Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.
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![Case 2.—Mrs. W , of Holbeck, a patient of Dr. Dodsoii's, with whom I saw her in September last year, aged thirty-five, has been married ten years, but never pregnant until the present case occcurred. Menstruation all her life (^uite regular and natural; tlic last period was about October 15tli, 1883, On December 3rd, having missed exactly seven weeks, she was slightly unwell, and had at the same time, to use her own words, a very violent pain in the body. The symptoms were such as would be produced by rupture of an early tubal gestation—viz., pain and collapse. She recovered from this, but the body went on increasing in size just as in normal pregnancy. At the end of August a sanguinolent discharge occurred, and this therefore may be taken as the time Avhen labour would liave taken place had gestation been uterine. 'J'he movements of the child, liowever, ceased to be felt about tlie end of tlie first week in Auiiust. Bv examination of tlie abdomen the outlines of the child were not perceptible as in tbe last case, l)ut some thick substance intervened, Avliich subsequently turned out to be the placenta. This mucli increased our difficulty in tlie diagnosis. There was a ])rojection outwartls of the abdominal walls in the right inguinal region, which felt not unlike a foot. There were no foetal or placental sounds audible. The uterus measured only two inches and three-quarters and the cervix was well open, so that the finger could be passed up to, but not through, the os internum. The pulse was weak, and the condition of the patient such that, being cpiite certain it was a case of abdominal extra- uterine gestation, we decided to remove the child at once. This was done on September 11th, 1884, at the Women and Children's Hospital. The incision was central, and we came, as expected, directly upon the placenta, the edge of which, however, was found about two inches to the right of the incision. Careful separation of the placenta in this direction did not produce luemorrhage. An incision at right angles to the first was now made, and the edge of the placenta being pushed back the feet of the child Avere seized, and it was removed without much difficulty, the placenta yielding without being torn or separated from its attachment to the abdominal walls. AVhether the child was enclosed in a cyst or not we were not quite certain at the time of the operation ; but, as proved afterwards, this was the case. There were no veins in the abdominal walls at the seat of the placental attachment except just at the lowest angle of the central incision. These I was careful to avoid wounding ; they were, however, oidy of small size. The wound was closed with silver wire, the funis being left out, and a drainage tube inserted, both at the extreme rigTit of the lateral incision. An attempt to separate the placenta with the finger and traction in about two weeks set up hemorrhage, and it was not attempted again until the discharge became very decidedly purulent at the end of six weeks. The whole of the placenta](https://iiif.wellcomecollection.org/image/b21448048_0103.jp2/full/800%2C/0/default.jpg)
