. Operative gynecology. th suppura-tion. 2. Tubal mole. 3. Tubal Extrusion into the uterus (in the interstitial form), anddevelopment to term. 6. Hupture within the foldsof the broad ligament, usuallywith the death of the fetus, inrare instances advancing toterm. 6. Hupture into the perito-neal cavity. (a) Followed by continuedgrowth of the fetus. (b) Death of fetus andmother. (c) Death of fetus alone with absorption (Leopold, Arohivf. Gyn., xviii, ; experiments on rabbits). (d) Death of fetus with a succession of hemorrhages ending in (1) supjiura-tion, peritonitis, and mater
. Operative gynecology. th suppura-tion. 2. Tubal mole. 3. Tubal Extrusion into the uterus (in the interstitial form), anddevelopment to term. 6. Hupture within the foldsof the broad ligament, usuallywith the death of the fetus, inrare instances advancing toterm. 6. Hupture into the perito-neal cavity. (a) Followed by continuedgrowth of the fetus. (b) Death of fetus andmother. (c) Death of fetus alone with absorption (Leopold, Arohivf. Gyn., xviii, ; experiments on rabbits). (d) Death of fetus with a succession of hemorrhages ending in (1) supjiura-tion, peritonitis, and maternal death; (2) siippuration and discharge externallyby the rectum, l)y the vagina, by the bladder, or by the abdominal walls. Multiple Pregnancy.—Numerous observations are recorded in which an extra-uterine and an intra-uterine pregnancy have occurred simultaneously. The course under such circumstances may be that of an extra-uterine preg-nancy with death of the fetus, followed later, it may be several years later, by. TuBAL MoLE FILLING AND DIS-TENDING THE isthmus is not affected, and the fimbriated end ia notat all distended. There was no free blood in the pelvis. Onehalf of the ovary left. Operation. Recovery. Oct. 20, size. 442 EXTEA-UTEKINE PREGNANCY. an intra-uterine pregnancy (see Coe, Amer. Jotir. Ohs., 1893, vol. xxvii, p. 855).The uterine pregnancy may then go on to term, or may terminate prematurelyin abortion. Inasmuch as the intra-uterine pregnancy is not abnormal, tlie in-dications for treatment must depend upon the extra-uterine pregnancy. Out ofeighteen cases (see Gutzwiller, Archiv f. Oyn., Bd. xliii, p. 223), ten maternallives were lost, and of the remaining eight, four were saved by celiotomies. Inone case both children were delivered alive, but the mother died. In the casecontributed by Gutzwiller the extra-uterine pregnancy advanced to the eighthmonth and the fetus died after an injury, and the intra-uterine pregnan
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