Volume 2

A system of gynecology and obstetrics / by American authors ; edited by Matthew D. Man and Barton Cooke Hirst.

Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: A system of gynecology and obstetrics / by American authors ; edited by Matthew D. Man and Barton Cooke Hirst. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    diabetes mellitus oecurs more frequently in tke pregnant than in the non-gravid woman. It is asserted that diabetic women arc less apt to conceive. When conception does occur, pregnancy is liable to interriqjtion from the death of the feetus. In 7 of 19 pregnancies occurring in 14 women, collected by Matthews Duncan,* the foetus died after reaching the age of viability. In 2 cases the child was feeble and died within a few hours of birth. In one case diabetes was observed in the infant. Hy- dramnion is of relatively frequent occurrence, and in one case the pres- ence of glucose in the fluid was demonstrated. It is alleged that the feetus is commonly of extraordinary size. The influence of pregnancy in developing a latent diabetic tendency may be accepted as highly probable. Bennewitz records an interesting case in which the disorder appeared in the fourth, fifth, and sixth preg- nancies, disappearing in the intervals. The fifth child was premature and stillborn. In the fifteen women the history of whose cases is narrated by Dun- can the age varied from twenty-one to thirty-eight years. Witli one e.xception they were multiparse. Four cases terminated fatally after delivery : in one of these death occurred after the induction of prema- ture labor. Death resulted fi’om collapse rather than from coma. The same observer^ has I'ccently reported certain cases of diabetes insipidus in pregnancy. One of them was congenital and persisted through eleven pregnancies. In another case four pregnancies occurred. Notable diminution in the amount of urea was observed. In the fragmentary state of our knowledge with reference to the di.s- tinctive characteristics conferred upon diabetes by pregnancy it is impossible to formulate general statements as to prognosis. There is great diversity of opinion upon the subject of the induction of ])remature labor. On a-priori grounds it would .seem to be indicated in the interest both of the mother and of the child in the graver cases. In the entire absence of authoritative clinical experience, however, the operation must be resorted to with an extreme degree of caution. Dise.vses of the Kidneys. Albmninuria.—Frequency.—Albumen, according to Schroedcr,® is found in the urine of from 3 to 5 per cent, of all pregnant Avomen, and is of still more frequent occurrence during labor. Ingerslev^ di.scovered albuminuria in 29 out of 600 pregnant Avomen, or in 4.8 per cent, of all cases. The albuminuria aa\ts of renal origin and of primary appear- ance during pregnancy in only 7 cases. It Avas referable to pre-exi.stent Bright’s disease in 1 case, and to catarrhal inflammation of the urinary ^ Obslcl. Trans., vol. xxiv. ^ Ibid., 1SS7. ^ hoc. ciL, p. 373. * Zeilschr.f. Gcb. u. Gyn., Bd. \’i. p. 176.