A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . s occupyseparate sacs the birth of one is not as apt to be interfered withby the other as where they occupy the same sac. Usually the combined weight of the foetuses exceeds thatof a single foetus, but not uncommonly one foetus seems to bedeveloped at the expense of the other, leading to the suggestionof immaturity. At times, one foetus dies during gestation, eitherfrom lack of proper blood-supply or, what really amounts to thesame thing, through compression exercised by one foetus
A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . s occupyseparate sacs the birth of one is not as apt to be interfered withby the other as where they occupy the same sac. Usually the combined weight of the foetuses exceeds thatof a single foetus, but not uncommonly one foetus seems to bedeveloped at the expense of the other, leading to the suggestionof immaturity. At times, one foetus dies during gestation, eitherfrom lack of proper blood-supply or, what really amounts to thesame thing, through compression exercised by one foetus on theother. AVhere the foetuses occupy a common sac the cord ofone may become entangled around the neck of the other, theresult being that through tightening of the cord this foetus iskilled. At times, in twin pregnancy, one foetus is born perfectin development whilst the other is imperfect, possibly to such adegree as to constitute a monstrosity. Again, where the foetusesoccupy a single sac fusion may occur at one or another part,giving rise to a species of monstrosity known as joined twins. PLATE Pygopagus (Tynberg). MANAGEMENT OF NORMAL AND ABNORMAL LABOR. 183 The junction may be at the head, or sternum, or back, or at thepelvis, an interesting example of the latter which we have seenbeing figured in Plate XXXVII. Again, one foetus may be in-cluded in the other,—so-called cases of fcetal inclusion. Detailsin reference to these cases of monstrosity will be found in worksdevoted to the subject. The diagnosis of multiple pregnancy is by no means asimple matter; indeed, in the average case only a presumptivediagnosis may be reached. The excessive size of the abdomen,where this is a factor, may be present in cases where there issimply an excess of liquor amnii. In case hydramnion compli-cates twin gestation, the diagnosis is concomitantly more diffi-cult, owing to the greater difficulty of making abdominal palpa-tion. Where, on auscultation, two fcetal hearts are hear
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Keywords: ., bookcentury1800, bookdecade1890, bookpubli, booksubjectobstetrics
