OBSTETRICS.
Successful Case of Caesarian Section. By Dr. Decoene.—The
author relates the following case of a female, aged 30, upon whom he
had once before performed the Caesarian operation. He saw the patient
in the seventh month of pregnancy, November 5, 1852, together with
Dr. Fredericy. She had then been forty hours in labor; and stated,
that, on the previous evening, she had experienced a breaking or yielding
sensation in the lower part of the abdomen, followed by discharges of
blood from the vagina, insensibility and sickness. Since that time, both
labor-pains and the movements of the child had ceased. The whole ab-
domen was very tender. Examination per vaginam detected a relaxed
os uteri, about the size of a dollar; but neither the head nor other part
of the child could be felt, although the limbs could be traced through
the abdominal walls. Inasmuch as the author concluded that the uterus
had given way, and the child had escaped into the abdomen, he deter-
mined upon an operation. After making the preliminary incisions, and
opening the peritoneum, he came upon a mass of congealed blood, under
which was a male infant, with the separated placenta, and the mem-
branes still entire. It was easily removed; then to the operator’s great
astonishment, a second child, female, came to view. Both infants were
dead. The uterus, which was contracted, exhibited along its front sur-
face a slit, answering to the line of incision of the former operation. No
haemorrhage ensued; the abdominal wound was united; and, by Novem-
ber 24th, the patient was well.— Gaz. des Hopitaux, 147; 1852.
Sicliel observes, in reviewing the above in Schmidt’s Jahrbuch, that
women, who have the good fortune to recover after the performance of
the Caesarian section, appear to be singularly liable to rupture of the
uterus along the line of the former incision in every subsequent preg-
nancy. Kaysen relates six such cases. The giving way of the cicatrix
in the earlier months of pregnancy may lead to escape of the ovum, and
the development of an extra-uterine growth.—Lond. Med. Times & Gaz.