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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![G4 PKFGNANCY TN BIl'ID UTERUS. These cases were, witli one exception, all under the seventh month. In the eighth and ninth months the walls of the uterus thickened, the qua'ntity of liquor aninii increased, and tlie cases terminated in perfectly natural labours. The exceptional case I have seen within the last few days, and the pregnancy liad advanced well into the eighth niontli. Vaginal examination makes it quite clear that the pregnancy was intra-uterine, whilst from the a})pearance of the abdomen alone the conclusion would have been inevitable that the child lay amongst the intestines. These facts were given to me in connection with Mr, Langley Browne's case, also witli a case whicli was watched by Dr. Hill Norris, and attended by him in her confinement. In Dr. Whitwell's case there was a large, thin-walled cyst, through which the child could be felt with tlie most astonishing distinctness, and it iloated about as if it were perfectly free in the abdomen. He wrote to me afterwards that the ])atient went on very well, that some time before the expiry of gestation the foetus became much more a fixed body, which undoubtedly showed an increased thickening of the walls of the uterus, as well as enlargement of the foetus, and that her labour was quick and without any subsequent haemorrhage. The other conditions with which extra-uterine pregnancy may be confused, before the death of the child, are (a) displacement of the normally pregnant uterus during the early months of pregnancy, complicated with fibro-myoma or cystic disease of the uterus ; and, more rarely, (&) pregnancy of one-half of a double uterus. In a case which I saw with the late Mr. Eoss, of Wake- field, I diagnosed either extra-uterine gestation or a double uterus with pregnancy of one side, and it turned out to be the latter. Frequently we have considerable lateral displacements of the normally pregnant uterus, especially in unmarried women, sent to the specialist as something very different to what they really are. But it is in cases seen after the death of the child, or at least when the time of the expected confinement has passed so long that if there is a child it is sure to be dead, that our most serious difficulties in diagnosis are met with. The first point to consider is the history given by the patient of her supposed pregnancy, and the events which occurred at and after the time of her expected delivery. It is somewhat remarkable, and I think it is in favour of the views of the pathology of tubal pregnancy which I have advanced, that the majority of the instances of this abnormality occur in women who have not borne children previously, or in those who have had no children for many years. This point in the history of the patient is therefore always noteworthy. The other matters requiring careful considera- tion are the sudden arrest of the menses, the gradual increase in size, the occurrence of symptoms of labour at or about the end of](https://iiif.wellcomecollection.org/image/b21448048_0068.jp2/full/800%2C/0/default.jpg)
