Vol 11, No 1 (1897)

Regarding the management of childbirth, complicated by a narrow pelvis of the 2nd degree, the opinions of obstetricians differ diametrically: some prefer to provide such childbirth to natural forces, just as it is practiced with normal pelvis. They resort to one or another operative intervention when life threatens mother or fetus; other obstetricians, on the contrary, under the same conditions, that is, with narrow pelvis of the 2nd degree, apply to the rotation of the fetus without showing for the immediate end of labor.

In the course of a relatively short time, I had to observe 7 similar cases, of which 6 were treated operatively and one case was purely expectant-symptomatic.

Infringement of a posteriorly curved pregnant uterus is one of the most serious and dangerous complications in the course of pregnancy and, if recognition is not delivered at the time, entails death in most cases.

Obstetrics and Gynaecology Society in St. Petersburg. Minutes No. VIII. Administrative meeting on November 14, 1896 chaired by K.F. Slavyanskiy.

The patient is 29 years old and is pregnant for the fourth time. In all previous pregnancies and in the present one, the patient had oedema of the limbs.

Most often, this suffering is observed in children and old women with general weakness, exhaustion, and also with a long existence of catarrh of the bladder.

Father 22 years old, mother 18 years old, both in good health. First delivery two months before due date; the baby is a boy, chronically well-fed, weighing about 6 pounds; his defecation is correct. The only abnormality in the structure of the body is the absence of the lower limbs.

In a child, in general, correctly developed, the author found a highly developed clitoris, similar to a penis, with an open head and foreskin.

This girl is a rickety child from a family with children who were over-age. In terms of height, body weight and other dimensions, the girl is larger than her age and corresponds to a child of 11 years of age.

The author observed the holeless hymen among (approximately) 10,000 patients who passed through his hands four times.

In this speech, the author draws a parallel between pre-colonial and modern surgery and assures us that surgeons had more talent back then, whereas nowadays a doctor can successfully perform both surgical and other medical activities with equal success.

The author found quantitative atrophy of the uterine muscles in dogs and rabbits after bilateral castration and, contrary to the results of Weissmann and Reissmann, no changes in the mucosa.

The author continues Schauta's work and treats the cases of eclampsia observed in the Second Vienna Clinic from 1880 to 1895.

In a 35-year-old woman with a multiple birth, who was suspected of an intrauterine pregnancy and therefore underwent a laparotomy, a hematoma the size of a chicken egg and an uterus bicornis with a pregnancy product in the right side of her left labrum were found.

There were 31 cases of all of these, and the majority of them were women between the ages of 20 and 30 who had already given birth more than once, and many of them had a longer or shorter interval between their last birth and their ectopic pregnancy. This leads us to believe that diseases after a long period of infertility could also have caused the abnormal pregnancy.

The object of the study was the material of the Kiel clinic for the last three years, namely the scraping products or the mucous membrane from the removed uterus.

The author recounts the history of two cases of uterine cancer he observed, in one of which the cancer was diagnosed in the seventh week of pregnancy and the uterus was successfully removed through the vagina. In the other case, although the delivery occurred at a normal term, it was a slow but completely normal delivery. Based on the literature, the author outlines the status of this disorder as a complication of pregnancy and childbirth.

Four weeks after 6 normal births, a 32-year-old woman showed blood, which lasted about two months and stopped only after a handful of placental masses were removed from the uterus.

As a result of the above reason, L. had the uterus and appendages removed through the sleeve 57 times over a period of ten years. Twenty cases are cited; the other 37 have been printed elsewhere.

Pointing to the need for individualization, L. recognizes that for the treatment of some of them the best is: castratio per laparatomiam; for others, whose myoma exceeds the size of the child's head — miomectomia with lowering or external attachment of the stump; in the third row of cases, the most appropriate: hatching myom per vaginam; the fourth group includes cases that not only need radical help, but which, in view of weakness, should be especially spared — for such, sleeve extirpation of the uterus is the most useful.

The French method of using tweezers for sleeve extirpation of the uterus with labor paves its way. Not only in Germany, but even among the compatriots of the founders of this method, there are quite a few authors who assert that this method of operation is “non-surgical and technically primitive”.

The article, the presentation and tone of which hardly fully corresponds to scientific work, treats the myomoctomy method used by the Leipzig University Gynecological Clinic and the results of 70 such operations for the period from 1892 to March 1896.

At the last day of the VI Pirogovsky congress in Kiev, the section of obstetrics and gynecology discussed the current state of the issue of pain relief in the birth process and came to the conclusion that its dissolution is an extremely important and urgent need of our humane age.