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Unterberger, F.: Plastic Operations on the Tubes, Tubal Insufflation, and Tubal Implantation
276
THE AMERICAN JOURNAL OF OBSTETRIC~ AND GYNECOWGY
h;bal orifice remains patent it js ai!visable to divide th<• proximal end into hw• flaps and sew the mucosa to the serosa. The length of the implanted part, should be as great as the interstitial portion :remon:d. .r. P. GEn:ENHTLL.
Unterberger, F.: Plastic Operations on the Tubes, Tubal Insu.tfta.tion, and Tubal Implantation. Monatsschrift fiir Geburtshilfe und Gynakologh\ 1925, lxxi, 6:l. In certain eases of tubal occlusion an attempt should be made to secure patency by operation. The author makes a 'f-incision in the occluded tube and everts the edges of the wound with catgut sutures. The ovary must be free and new wound surfaces avoided. Nearly always the operation is combined with a ventro-fixation. This operation lfas performed 57 times by the author, in most cases as an acc.essory operation to the main indication for laparotomy. There was no mortality and five women (8.77 per cent) became pregnant after the operation. In four of these five patients tubal c.losure had been due to perisalpingitis and in only one had there been an endosalpingitis. The author has also performed tubal implantation three times. In the first case a Rubin test after the operation shGwed that the implanted tube was patent. In one case no menses appeared after operation and this patient is now pregnant after lllh 3 ears of sterility. This is the 1hst case of pregnancy following n tubal implantation in Europe. The author believes this patient should be delivered by cesarean section because the site of implantat!on into the uterus is a locus minoris resistentiae. Whether the danger of rupture of the uterus after tubal implantation is greater than the scar left after a deep myomectomy is still an open question. J. P. GREENHILL.
Cullen: .A. Normal Pregnancy Following Insertion of the OUter Half of a, ~allo pian Tube Into the Uterine Cornu. Bulletin of the Johns Hopkins Hospitai, 1922, xxxiii, 344. Patient was operated upon October 6, 1919, for left cornual pregnancy. This was removed, saving the outer half of the left tube and suturing its inner end into the uterine horn. Her right tube and ovary had been removed by another aurgeon several years before. On March 11, 1921, she had a stillborn child at the end of the seventh month of gestation. There was a placenta previa. June 26, 1922, she had a normal labor and a living child. C. 0. MALAN{}.
The Dangers and Besults of the Use of Contracon~ve Instruments SUch as the Obturator, Sterilet or Fructulet of Nassauer. Schweizer medizinische Wochenschrift, 1924, liv, 650.
Reist:
A large number of infections and deaths occur from the use of val'ious instruments employed for the purpose of preventing pregnancy. He condemns in no uncertain terms the use of the coutraconceptive ''pessary'' of any sort and offers the following list of cases he has collected: Deaths-general peritonitis and sepsis 17; V~o1despread parametritis 70; general peritonitis 38; pelvic peritonitis 6; septic abortion 62; damage to uterine wall by instruments 5; perforation of uterus 1; of bladder 2 and of pouc.h of Douglas 1. Septic endometritis with involvement of surrounding tissue 75; pressure ulc.ers of cervix or uterine body 12; uncontrollable uterine bleeding 60; crampy uterine pain 28, and ectopie. pregnaneies 4. A. C.· WILLIAMSON.
THE AMERICAN JOURNAL OF OBSTETRIC~ AND GYNECOWGY
h;bal orifice remains patent it js ai!visable to divide th<• proximal end into hw• flaps and sew the mucosa to the serosa. The length of the implanted part, should be as great as the interstitial portion :remon:d. .r. P. GEn:ENHTLL.
Unterberger, F.: Plastic Operations on the Tubes, Tubal Insu.tfta.tion, and Tubal Implantation. Monatsschrift fiir Geburtshilfe und Gynakologh\ 1925, lxxi, 6:l. In certain eases of tubal occlusion an attempt should be made to secure patency by operation. The author makes a 'f-incision in the occluded tube and everts the edges of the wound with catgut sutures. The ovary must be free and new wound surfaces avoided. Nearly always the operation is combined with a ventro-fixation. This operation lfas performed 57 times by the author, in most cases as an acc.essory operation to the main indication for laparotomy. There was no mortality and five women (8.77 per cent) became pregnant after the operation. In four of these five patients tubal c.losure had been due to perisalpingitis and in only one had there been an endosalpingitis. The author has also performed tubal implantation three times. In the first case a Rubin test after the operation shGwed that the implanted tube was patent. In one case no menses appeared after operation and this patient is now pregnant after lllh 3 ears of sterility. This is the 1hst case of pregnancy following n tubal implantation in Europe. The author believes this patient should be delivered by cesarean section because the site of implantat!on into the uterus is a locus minoris resistentiae. Whether the danger of rupture of the uterus after tubal implantation is greater than the scar left after a deep myomectomy is still an open question. J. P. GREENHILL.
Cullen: .A. Normal Pregnancy Following Insertion of the OUter Half of a, ~allo pian Tube Into the Uterine Cornu. Bulletin of the Johns Hopkins Hospitai, 1922, xxxiii, 344. Patient was operated upon October 6, 1919, for left cornual pregnancy. This was removed, saving the outer half of the left tube and suturing its inner end into the uterine horn. Her right tube and ovary had been removed by another aurgeon several years before. On March 11, 1921, she had a stillborn child at the end of the seventh month of gestation. There was a placenta previa. June 26, 1922, she had a normal labor and a living child. C. 0. MALAN{}.
The Dangers and Besults of the Use of Contracon~ve Instruments SUch as the Obturator, Sterilet or Fructulet of Nassauer. Schweizer medizinische Wochenschrift, 1924, liv, 650.
Reist:
A large number of infections and deaths occur from the use of val'ious instruments employed for the purpose of preventing pregnancy. He condemns in no uncertain terms the use of the coutraconceptive ''pessary'' of any sort and offers the following list of cases he has collected: Deaths-general peritonitis and sepsis 17; V~o1despread parametritis 70; general peritonitis 38; pelvic peritonitis 6; septic abortion 62; damage to uterine wall by instruments 5; perforation of uterus 1; of bladder 2 and of pouc.h of Douglas 1. Septic endometritis with involvement of surrounding tissue 75; pressure ulc.ers of cervix or uterine body 12; uncontrollable uterine bleeding 60; crampy uterine pain 28, and ectopie. pregnaneies 4. A. C.· WILLIAMSON.