. A system of midwifery, including the diseases of pregnancy and the puerperal state. to delivery,nothing is open to us beyond free incision, which may be made in themost dependent portion of the tumor, and of such size as its dimen- XXXV.] UTERINE POLYPUS. 575 sions may seem to render necessary. The immediate effects of gan-grene and suppuration, and their probable results, will, of course, insuch a case excite, and with good cause, the serious apprehension of theaccoucheur. Among the other tumors which may be encounteredduring labor, we may mention, in addition to those which have alreadybee
. A system of midwifery, including the diseases of pregnancy and the puerperal state. to delivery,nothing is open to us beyond free incision, which may be made in themost dependent portion of the tumor, and of such size as its dimen- XXXV.] UTERINE POLYPUS. 575 sions may seem to render necessary. The immediate effects of gan-grene and suppuration, and their probable results, will, of course, insuch a case excite, and with good cause, the serious apprehension of theaccoucheur. Among the other tumors which may be encounteredduring labor, we may mention, in addition to those which have alreadybeen detailed, phlegmonous enlargements, cysts, syphilitic vegetations,and such tumors as have been figured by Martin in his Atlas, as dueto hypertrophy or degeneration of the nymphae and preputium clitori-dis,—all of which must be managed on ordinary surgical principles. Polypoid tumors, springing from the uterus, may sometimes con-stitute very serious obstacles to delivery, as is here shown. The mereexistence of a tumor of this character is not, however, to be accepted Fig. Uterine polypus as an obstacle to delivery. as evidence of a condition which absolutely prohibits the passage ofthe child, as much will depend upon the mobility as well as the com-pressibility of the tumor. In a case published by Dr. Beatty, towhich Dr. Churchill refers, the tumor was so large and apparentlyso fixed, that Caesarian Section was anticipated ; nevertheless, at thetime of labor, it was elevated sufficiently to allow of the birth of thechild without any assistance. In some cases of polypi with a narrowpedicle, the effect of continued pressure and extensive effort has beento detach the growth, and expel it in advance of the child. The man-agement of such cases will depend, in a great measure, upon the con-ditions already mentioned. If, for example, it is movable, and thehead has not yet descended into the pelvis, so as to render such a resultimpossible of attainment, we should try, as has i
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectobstetrics, bookyear1
