Operative midwifery : a guide to the difficulties and complications of midwifery practice . -, 1902, p. 95. 2 La Clinica Ostetr., vol. vi., Nos. 1-9. 10 1 16 OPERATIVE MIDWIFERY amputated, although the latter condition probably more often resultsfrom amnionic bands and errors of development. The mosl interest-ing cases of knotting are those in which two or more knots haveoccurred in the cords of twin foetuses in one amnionic Bac. Suchcases are very rare. An example is seen in the accompanying illus-tration (Fig. 78). Dr. Lindsay, of Glasgow, very kindly gave me thespecimen. The knots, if they
Operative midwifery : a guide to the difficulties and complications of midwifery practice . -, 1902, p. 95. 2 La Clinica Ostetr., vol. vi., Nos. 1-9. 10 1 16 OPERATIVE MIDWIFERY amputated, although the latter condition probably more often resultsfrom amnionic bands and errors of development. The mosl interest-ing cases of knotting are those in which two or more knots haveoccurred in the cords of twin foetuses in one amnionic Bac. Suchcases are very rare. An example is seen in the accompanying illus-tration (Fig. 78). Dr. Lindsay, of Glasgow, very kindly gave me thespecimen. The knots, if they are tight, invariably lead to the deathof the child. The condition naturally is only recognized after theexpulsion of the placenta and Fig. 78.—Placenta and Knotted Cords, from a Case of Twin Pregnancy.(Specimen kindly given the Author by Dr. Lindsay.) The various anomalies in the number and relationship of thevessels in the umbilical cord cannot be considered here. It is other-wise, however, with the insertion of the cord to the placenta. Themarginal insertion—often termed battledore placenta—is an abnor-mality occurring in about 5 per cent, of cases. To a slight extent itis a source of danger to the child. Much more serious, however, is thevelamentous insertion (Fig. 79), for in such cases the circulation isvery readily interfered with. Rupture of the vessels and death ofthe child from haemorrhage have been noted on several occasions. COMPLICATIONS CONNECTED WITH THE COW) 147 The etiology of the condition has been discussed by Schultz,Kustner, Ahlfeld, and others, but, as it has no practical bearing,those interested in the matter are referred to the monographs onthe subject by the authors mentioned. It is qui
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