Transactions of the American Association of Obstetricians and Gynecologists for the year ... . ating subperitoneal musclefibers which normally form the external coat of the uterus. Con-tributing causes are a short genital mesentery and hypertrophiedround ligaments which, if short, tend to drag the ducts apart. The clinical observations, which are very numerous, tend tomake the cases fall into several classes according to the age of thepatient, the kind and extent of the malformation, and the com-plicating conditions. IYom a perusal of the literature, it is evident that cases ofdouble uterus wi
Transactions of the American Association of Obstetricians and Gynecologists for the year ... . ating subperitoneal musclefibers which normally form the external coat of the uterus. Con-tributing causes are a short genital mesentery and hypertrophiedround ligaments which, if short, tend to drag the ducts apart. The clinical observations, which are very numerous, tend tomake the cases fall into several classes according to the age of thepatient, the kind and extent of the malformation, and the com-plicating conditions. IYom a perusal of the literature, it is evident that cases ofdouble uterus with both uteri equally developed and normal, are 354 UTERUS SEPTUS. 355 rather rare. Usually there is at least one side which showsmarked atresia and gives rise to abnormal symptoms and signsunder certain conditions to be discussed later. Cramer(3)reports a case of complete double uterus in which pregnancy tookplace simultaneously in each side, labor came on independentlyin each uterus and was completed without mishap except severepostpartum hemorrhage. Such cases are, however, rarely Fig. I. although it has been suggested that many cases of double uterusgo through a normal childbearing life without ever being the cases fall into the following groups: A. Those Consulting the Physician at Puberty for AbnormalMenstrual Phenomona.—These cases, of which twenty-three hadbeen collected by Durlacher(i4) up to 1909, come to the physician 356 H . E L L I N G T O N YATES, complaining of pain and swelling at the menstrual period andwith or without menstrual blood showing, dependent uponwhether both sides or one is atresia. Examination shows hema-tometra on the defective side. Sometimes this breaks throughspontaneously. B. Those Showing Purulent Processes in the Atresic Half ofthe Uterus.—These cases are much rarer. Breisky (28), Sicherer(29) Peham(3o), C7Usserow(3i), have reported such cases. Just
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