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The significance and management of fibromyomata complicating pregnancy
Follow-up information obtained four months after delivery from the pediatricians who were in contact with t,he cases revealed that in no incidence was there any residual deformity or limitation of motion. The number of clavicle fractures diagnosed clinically without routine x-ray Since this study was completed, all newborn infants examination is of interest. have been examined on discharge from t,he hospital by one of two members of the pediatric house staff. Attention has been focused on this injury and it was specially looked for in each case. In the 655 vertex deliveries occurring between the termination of these studies and this writing, only one fractured clavicle has been diagnosed clinically. This is an incidence of 0.2 per cent.
Summary 1. One and seven-tenths per cent of 300 full-t,erm infants born by vert,ex deliveries had silent fractures of the clavicle as determined by routine x-ray examination. 2. None of these was recognized clinically prior to the x-ray examination. 3. X-ray pelvimetry on the five mothers showed no significant abnormality. 4. This injury heals spontaneously without treatment. 5. No residual deformity or limitation of motion resulted from these fractures.
References 1. 2. 3. 4. 5. 6. 7.
Adler, 8.: Zentralbl. f. Gynak. 52: 879, 1928. Hatch, E.: Zentralbl. f. GynPk. 29: 1025, 1905. Hedberg, G. T.: Acta obst. et gynec. Scandinav. 24: Fast. 3, 1946. Hukewytsch, B.: Monatschr. f. Geburtsh. u. Gyniik. 83: 2.5, 1929. Muus, N.: Zentralbl. f. GynLk. 27: 689, 1903. Reithcr, G.: Wien. klin. Wehnschr. 15: 619. 1902. Troitzkaja: Cited by Hukewytsch.4
Trites, A. E.: The Significance and Management nancy, Canad. M. A. .J. 59: 539, 1948.
of
Fibromyomata
Complicating Preg-
The author reports H. total of eighty-seven patients with myomas of the uterus eomplicating pregnancy (4.7 per cent) between 1936 and 1948. The most common complication occurring in these cases (luring pregnancy is degeneration with all of its attending symptoms. Severe necrobiosis or torsion of a pedunculated tumor may necessitate surgical intervention. Toward the end of pregnancy every effort should be made to temporize. In these eighty-seven cases, thirteen abortions and nine premature labors occurred. Dystocia may be produced by large myomas as a result of obstruction of the birth canal. The incidence of cesarean section was 18 per cent, but only in 12.5 per cent were the myomas responsible for the section either directly or indirectly. In the author’s hands, hysterectomy during cesarean section has definite advantage over myomectomy. The patients have a smoother convalescence. The exception to this is in the young primipara in whose case conservatism is the procedure of choice. Morbidity was present in twelve patients in this series. The aftertreatment of the parturient woman with fibroids can be along expectant lines with the indication for operation heing on the same basis as for 6bro. mvomas in general. WILLIAM BERMAK.
Summary 1. One and seven-tenths per cent of 300 full-t,erm infants born by vert,ex deliveries had silent fractures of the clavicle as determined by routine x-ray examination. 2. None of these was recognized clinically prior to the x-ray examination. 3. X-ray pelvimetry on the five mothers showed no significant abnormality. 4. This injury heals spontaneously without treatment. 5. No residual deformity or limitation of motion resulted from these fractures.
References 1. 2. 3. 4. 5. 6. 7.
Adler, 8.: Zentralbl. f. Gynak. 52: 879, 1928. Hatch, E.: Zentralbl. f. GynPk. 29: 1025, 1905. Hedberg, G. T.: Acta obst. et gynec. Scandinav. 24: Fast. 3, 1946. Hukewytsch, B.: Monatschr. f. Geburtsh. u. Gyniik. 83: 2.5, 1929. Muus, N.: Zentralbl. f. GynLk. 27: 689, 1903. Reithcr, G.: Wien. klin. Wehnschr. 15: 619. 1902. Troitzkaja: Cited by Hukewytsch.4
Trites, A. E.: The Significance and Management nancy, Canad. M. A. .J. 59: 539, 1948.
of
Fibromyomata
Complicating Preg-
The author reports H. total of eighty-seven patients with myomas of the uterus eomplicating pregnancy (4.7 per cent) between 1936 and 1948. The most common complication occurring in these cases (luring pregnancy is degeneration with all of its attending symptoms. Severe necrobiosis or torsion of a pedunculated tumor may necessitate surgical intervention. Toward the end of pregnancy every effort should be made to temporize. In these eighty-seven cases, thirteen abortions and nine premature labors occurred. Dystocia may be produced by large myomas as a result of obstruction of the birth canal. The incidence of cesarean section was 18 per cent, but only in 12.5 per cent were the myomas responsible for the section either directly or indirectly. In the author’s hands, hysterectomy during cesarean section has definite advantage over myomectomy. The patients have a smoother convalescence. The exception to this is in the young primipara in whose case conservatism is the procedure of choice. Morbidity was present in twelve patients in this series. The aftertreatment of the parturient woman with fibroids can be along expectant lines with the indication for operation heing on the same basis as for 6bro. mvomas in general. WILLIAM BERMAK.