File:Interstate medical journal (1907) (14763013792).jpg

Identifier: interstatemedica1419unse (find matches)
Title: Interstate medical journal
Year: 1907 (1900s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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f membranes. foetal parts could not be outlined and no foetal heart sounds were audibleon auscultation. On vagino-abdominal and recto-abdominal palpation, cervix was foundopen sufficiently to admit one finger. The uterus was central, softenedand enlarged and a large, hard mass was found to the right and slightlyposterior to it. It was slightly movable and gave but very little discomforton pressure. There being no special indication to operate immediately, for the pa-tient was comfortable, she was kept under close observation. A CASE OF TUBAL ABORTION. 461 The several blood examinations made showed, as follows:August 17—Haemoglobin, 85 per cent. Leucocyte Count, 10,266.Erythrocyte Count, 3,876,000.October 16—Haemoglobin, 95 per cent. Leucocyte Count, 16,132.November 16—Haemoglobin, 100 per cent. Leucocyte Count, 10,400. (Day before opera-tion) My purpose in waiting up to this date before operating, was to givethe foetus a chance to develop to a viable age, if alive, for since she
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Fig. 3.—Placenta.—Shows another aspect of same specimen two-thirds natural size. was under constant observation, there was little danger in this, as im-mediate operation could have been decided upon had she developed anyuntoward symptoms. Laparotomy was performed on November 17, 1906, and disclosed thefollowing interesting pathology: The foetus was partially enveloped by the thoroughly adherent omen-tum and was located in the region of the umbilicus or even slightly 462 ELBRECHT. above it, and showed no trace of any cordal attachment to the placenta,which was plainly visible in the right tube. The ostium of the tube was perfectly sealed by the membranes andcontained about one-half ounce of fluid, apparently serum. The entire placental tissue occupied only the outer third of the tube,which was greatly distended and thickened, and thus accommodated theamount of pressure it withstood before aborting, and no protrusion orexternal evidence of a cord could be found. This proves that the

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