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Ovarian tumors complicating pregnancy, labor, and the puerperium
REVIEWS
AND
ABSTRACTS
147
a survey of his own statistics, he concludes: (1) Fibroid tumors in the puerperium may cause serious complications, frequently a febrile course. (2) Fibroid tumors themselves may suffer changes during gestation and labor, and these may progress and even be augmented by secondary infection during the puerperium. (3) When a woman with a fibromyomatous uterus becomes pregnant and goes to term, cesarean section with an immediate myomectomy or hysterectomy is the operation of choice. (4) When the myoma is not discovered until during labor or in the puerperium, con. servatism should be practiced as long as possible. WM. C. HENSEX. De Gaudino, Adaria Teresa I?.: Ovarian Tumors Complicating Pregnancy, Labor, arid the Puerperium. Semana medica, Buenos Aires, 1!921, xxviii, 389. Ten instances of this complication are reported occurring in 13,313 deliveries. Two of these were at term, and were explored by the abdominal route. In both cases, it was impossible to expose the tumor sufficiently without drawing the uterus forward in such a way as to endanger the blood supply to the placental site; consequently a cesarean section was necessary in each case. In the third ease the diagnosis of a cyst was made during labor and it was punctured through the vagina. Cases 4 and 5 were cysts removed by laparotomy during the fifth and six months. The sixth patient left the clinic before labor. Case 7 was that of a patient with a cyst which ruptured during labor; a laparotomy was done the second day postpartum and drainage established, but the patient died of peritonitis. The eighth case was operated on two months after delivery, the tumors having been mistaken for inflammatory masses. The ninth and tenth cases were of tumors removed during the puerperium, the former for a twisted pedicle, the latter for malignancy. Ovarian tumors diagnosed during the first months of pregnancy should be removed. In the last months those tumors localized in the abdomen and not interfering with labor should be let alone until after the puerperium. Pelvic ovarian tumors which cause dystocia should be removed during labor, without cesarean section whenever possible. During the puerperium such patients should be treated according to the symptoms caused by the tumor. THOS. R. GOETEALS. Hermans: Acute Appendicitis during Pregnancy, Labor, and the Puerperium. Nederlandsch Tijdschrift voor Geneeskunde, 1924, ii, 1004. Hermans does not believe that pregnancy is a predisposing factor of any great consequence, but does not doubt that a latent or chonic appendicitis may be activated by pregnancy. He reviews the literature and his own cases and comes to the following conclusions: Appendicitis may complicate pregnancy at any stage, even during delivery. As a rule, the diagnosis during pregnancy, labor, and the puerperium is not especially difiicult, the main point being to bear in mind the possibility of its occurrence. Only by prompt operation can the prognosis be improved, the earlier the diagnosis and operation, the better for mother and child. He agrees with Cooke : “In ease of doubt operation is safer than waiting.” R. E. WOBUS. TtSdenat: Appendicitis Among Pregnant Women. trique et de Gynecologie, 1925, xiv, 237.
Bulletin
de la Soeiete d’obste.
In the French literature there is a marked paucity of information regarding appendicitis during pregnancy and the puerperium. In the Baudelocque Hospital in Paris, among 11,479 labors during a period of six years, there was only one case of appendititis.
AND
ABSTRACTS
147
a survey of his own statistics, he concludes: (1) Fibroid tumors in the puerperium may cause serious complications, frequently a febrile course. (2) Fibroid tumors themselves may suffer changes during gestation and labor, and these may progress and even be augmented by secondary infection during the puerperium. (3) When a woman with a fibromyomatous uterus becomes pregnant and goes to term, cesarean section with an immediate myomectomy or hysterectomy is the operation of choice. (4) When the myoma is not discovered until during labor or in the puerperium, con. servatism should be practiced as long as possible. WM. C. HENSEX. De Gaudino, Adaria Teresa I?.: Ovarian Tumors Complicating Pregnancy, Labor, arid the Puerperium. Semana medica, Buenos Aires, 1!921, xxviii, 389. Ten instances of this complication are reported occurring in 13,313 deliveries. Two of these were at term, and were explored by the abdominal route. In both cases, it was impossible to expose the tumor sufficiently without drawing the uterus forward in such a way as to endanger the blood supply to the placental site; consequently a cesarean section was necessary in each case. In the third ease the diagnosis of a cyst was made during labor and it was punctured through the vagina. Cases 4 and 5 were cysts removed by laparotomy during the fifth and six months. The sixth patient left the clinic before labor. Case 7 was that of a patient with a cyst which ruptured during labor; a laparotomy was done the second day postpartum and drainage established, but the patient died of peritonitis. The eighth case was operated on two months after delivery, the tumors having been mistaken for inflammatory masses. The ninth and tenth cases were of tumors removed during the puerperium, the former for a twisted pedicle, the latter for malignancy. Ovarian tumors diagnosed during the first months of pregnancy should be removed. In the last months those tumors localized in the abdomen and not interfering with labor should be let alone until after the puerperium. Pelvic ovarian tumors which cause dystocia should be removed during labor, without cesarean section whenever possible. During the puerperium such patients should be treated according to the symptoms caused by the tumor. THOS. R. GOETEALS. Hermans: Acute Appendicitis during Pregnancy, Labor, and the Puerperium. Nederlandsch Tijdschrift voor Geneeskunde, 1924, ii, 1004. Hermans does not believe that pregnancy is a predisposing factor of any great consequence, but does not doubt that a latent or chonic appendicitis may be activated by pregnancy. He reviews the literature and his own cases and comes to the following conclusions: Appendicitis may complicate pregnancy at any stage, even during delivery. As a rule, the diagnosis during pregnancy, labor, and the puerperium is not especially difiicult, the main point being to bear in mind the possibility of its occurrence. Only by prompt operation can the prognosis be improved, the earlier the diagnosis and operation, the better for mother and child. He agrees with Cooke : “In ease of doubt operation is safer than waiting.” R. E. WOBUS. TtSdenat: Appendicitis Among Pregnant Women. trique et de Gynecologie, 1925, xiv, 237.
Bulletin
de la Soeiete d’obste.
In the French literature there is a marked paucity of information regarding appendicitis during pregnancy and the puerperium. In the Baudelocque Hospital in Paris, among 11,479 labors during a period of six years, there was only one case of appendititis.