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Extrauterine pregnancy
TII this series 0%’ 31, only two had a second. tubal pregnancy, that is the chances ‘-0~: a normal intrauterine pregnancy are about six times as great as for a reSeated extrauterine. These results therefore justify conservatism in the treatsent of the opposite apparently normal. tube. BURG~RET 8c~orz~.
BerHand:~x~r~~terine regnmcy. 1924,
Nederlands&
Tijdsshrift
voor
Geneeskunde,
i, 326.
Yhe basis of this very detailed analysis are 116 cases. Of these 98 were treated ,iouservatively, while 98 were operated, 92 by laparotomy and 6 by eolpotomy. The fatal cases had all been subjected to laparotomy, These were all received in a desperate clondition and immediately subjected ;o Iaparotomy. In three of these cases abortion had been attempted and probIbly also in a fourth ease, however peritonitis was the cause of death in only :>ne of these. An attempt at abortion had been made in at least ‘I other cases. Your of the fatal. eases were in eztremis when operated and in two of these the ‘Ileeding was still active at the time of operation. Active bleeding was en;ountered in 12 per cent of all operated eases. One patient died 5 days after operation {peritonitis). Of the conservatively treated cases the diagnosis was considered eertain in Since exploratory puncture i0, almost certain in 6, and probable in the rest. was abandoned some years ago, conservative treatment also has become less frepent. Of 58 women in whom further pregnancy was possible, 30 later became pregLIUIC one or more times (14 abortions and 35 live children). In addition, 5 had i subsequent ectopic gestation. Is. 33, wosvs. Etigelmann, narroy.
If?. : The Medizinisehe
Mecessity Klinik,
and ResuBs of 1923, xix> 535.
Early
Operation
In
Tubal.
During the past year at the Dortmund Frauenklinik, three times as many q-omen as formerly were operated upon for extrauterine pregnancy. This the author attributes to the increase in pelvic infections, and the latter are due not 33 much to gonorrhea as to criminally induced or improperly handied a.bortions. The afebrile patients stayed in the hospital on an average of 14 days while :ae febrile ones remained 30 days. Furthermore the latter were semi-invalids ‘or a variable length of time afterwards. The author emphasizes that the fate -i’ women with tubal pregnancy is dependent upon an early diagnosis and early ,+eration. If one waits too long fever develops. Of iate in the mildly febrile :tises, the author has waited until the temperature subsided and then operated ;5th success. J. P. GREENHILL Me;lendaU, Kbnik,
H. : Important Questions 1923, xix, 311 and 341.
rewarding
Tribal
Pregnancy.
Xedizinisehe
Jn the literature up to the present time there have been only fourteen reports o:- attempted abortion in cases of extralrterine pregnancy. Eellendall reports the fifteenth case, Of the Steen eases, eleven were cured by laparotomy. The &hers died of peritonitis. Since this mortality is much higher than occurs when Xbortion is attempted in intrauterine pregnancy, the former cases must Se very susceptible to serious infection. it is important in these eases to operate early* The association of attempts at abortion and eotopic pregnancy is more fre:;cent than is supposed. The occnrrenee of fever after operation for tubal preg~laney may in some eases be due to previous attempts to produce abortion.
BerHand:~x~r~~terine regnmcy. 1924,
Nederlands&
Tijdsshrift
voor
Geneeskunde,
i, 326.
Yhe basis of this very detailed analysis are 116 cases. Of these 98 were treated ,iouservatively, while 98 were operated, 92 by laparotomy and 6 by eolpotomy. The fatal cases had all been subjected to laparotomy, These were all received in a desperate clondition and immediately subjected ;o Iaparotomy. In three of these cases abortion had been attempted and probIbly also in a fourth ease, however peritonitis was the cause of death in only :>ne of these. An attempt at abortion had been made in at least ‘I other cases. Your of the fatal. eases were in eztremis when operated and in two of these the ‘Ileeding was still active at the time of operation. Active bleeding was en;ountered in 12 per cent of all operated eases. One patient died 5 days after operation {peritonitis). Of the conservatively treated cases the diagnosis was considered eertain in Since exploratory puncture i0, almost certain in 6, and probable in the rest. was abandoned some years ago, conservative treatment also has become less frepent. Of 58 women in whom further pregnancy was possible, 30 later became pregLIUIC one or more times (14 abortions and 35 live children). In addition, 5 had i subsequent ectopic gestation. Is. 33, wosvs. Etigelmann, narroy.
If?. : The Medizinisehe
Mecessity Klinik,
and ResuBs of 1923, xix> 535.
Early
Operation
In
Tubal.
During the past year at the Dortmund Frauenklinik, three times as many q-omen as formerly were operated upon for extrauterine pregnancy. This the author attributes to the increase in pelvic infections, and the latter are due not 33 much to gonorrhea as to criminally induced or improperly handied a.bortions. The afebrile patients stayed in the hospital on an average of 14 days while :ae febrile ones remained 30 days. Furthermore the latter were semi-invalids ‘or a variable length of time afterwards. The author emphasizes that the fate -i’ women with tubal pregnancy is dependent upon an early diagnosis and early ,+eration. If one waits too long fever develops. Of iate in the mildly febrile :tises, the author has waited until the temperature subsided and then operated ;5th success. J. P. GREENHILL Me;lendaU, Kbnik,
H. : Important Questions 1923, xix, 311 and 341.
rewarding
Tribal
Pregnancy.
Xedizinisehe
Jn the literature up to the present time there have been only fourteen reports o:- attempted abortion in cases of extralrterine pregnancy. Eellendall reports the fifteenth case, Of the Steen eases, eleven were cured by laparotomy. The &hers died of peritonitis. Since this mortality is much higher than occurs when Xbortion is attempted in intrauterine pregnancy, the former cases must Se very susceptible to serious infection. it is important in these eases to operate early* The association of attempts at abortion and eotopic pregnancy is more fre:;cent than is supposed. The occnrrenee of fever after operation for tubal preg~laney may in some eases be due to previous attempts to produce abortion.