Gynecological diagnosis . er. i. Pregnancy.—It should be assumed, until the contrary hasbeen proven, that every abdominal enlargement in a woman isdue to pregnancy. In this way many embarrassing mistakes willbe avoided. The diagnosis of early pregnancy lias been consideredin treating of the small ovarian tumors. Advanced pregnancy isto be excluded by the history. It is possible to have amenorrheain ovarian tumor, especially where both ovaries have become dis- 20 306 DIAGNOSIS OF DISEASES OF THE OVARIES organized by the disease affecting them, but it is unusual. Morn-ing nausea and vomiting dur
Gynecological diagnosis . er. i. Pregnancy.—It should be assumed, until the contrary hasbeen proven, that every abdominal enlargement in a woman isdue to pregnancy. In this way many embarrassing mistakes willbe avoided. The diagnosis of early pregnancy lias been consideredin treating of the small ovarian tumors. Advanced pregnancy isto be excluded by the history. It is possible to have amenorrheain ovarian tumor, especially where both ovaries have become dis- 20 306 DIAGNOSIS OF DISEASES OF THE OVARIES organized by the disease affecting them, but it is unusual. Morn-ing nausea and vomiting during the early months, or salivationand heartburn and swelling of the breasts, are characteristic of preg-nancy. Sometimes these symptoms have occurred at a giventime with previous pregnancies. Ask whether they have beenobserved this time since the patient first noticed the enlargementof the abdomen. Quickening is usually noticed at the end of the sixteenth weekof pregnancy. The signs of pregnancy in the later months are. Fig. 130.—The Height of the Fundus Uteri at the Various Weeks of Pregnancy (After Zweifel.) softening of the cervix, increased vaginal discharge, ballottementafter the twenty-first week. Fluctuation in the uterus is. veryindistinct unless the liquor amnii is in excess and the uterine wallsare thin from any cause. By careful palpation the intermittentrhythmical contractions of the pregnant uterus may be felt asearly as the fourth month. A good deal of patience, gentleness,and skill are necessary to get this sign. Purplish discoloration LARGE OVARIAN TUMORS 307 of the vulva and anterior wall of the vagina are to be made out fromthe sixth to the twelfth week. If milk or colostrum can be s< raeezei Ifrom the breasts it is an important indication of pregnancy. Fetal heart sounds can be heard after the twentieth week, andfetal movements can be felt after the sixteenth week unless thefetus is dead. The tumor has developed relatively rapidly; thereis pigmentatio
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectwomen, bookyear1910
