Two cases of impracticable labour arising from malacosteon of the pelvis, in which the caesarean operation was performed; accompanied with practical observations / [Thomas Radford].

  • Radford, Thomas, 1793-1881.
Date:
[1841]
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of impracticable labour arising from malacosteon of the pelvis, in which the caesarean operation was performed; accompanied with practical observations / [Thomas Radford]. Source: Wellcome Collection.

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    gruel; to take 40 minims of laudanum. The symptoms continu¬ ed to grow more unfavourable during the night, and she died at 4 o’clock this morning, (Tuesday,)about 35 hours after the operation. An application was made to examine the body, but permission was only granted under a promise that the wound was alone to be inspected ; but Mr Morris while alone took the opportunity of as¬ certaining, as far as he was able, the state of the parts. The edges of the external wound were quite separate, and had a flabby unhealthy aspect. Having divided the stitches and drawn aside the integuments, the uterus was observed to be well contracted. The wound was much diminished, its edges were loose and unheal¬ thy. The peritoneum was inflamed, and about from four to six ounces of serum were effused within its cavity. Upon again raising the uterus, the cervix was seen to be dark-coloured ; and having divided it, the lower portion and orifice were found in a gangrenous state. The bladder was empty and uninjured. The brim of the pelvis was examined, and found fully as much distorted as I have before-mentioned. Remarks.—The issue of this case presents indisputable evidence of the serious mischief arising from protracting the operation. Both the life of the mother and the child were most likely forfeited by the delay. How the real character of the case could have been so much overlooked, after the clear and decided opinion of Mr Wood given at the end of the seventh month, I am at a loss to conceive. The tumefaction of the external genitals, and the inflamed con¬ dition of the vagina, are alone to be attributed to the too frequent examinations made. When a practitioner undertakes to explore for the exact measurements of the brim of a pelvis, deformed like the one belonging to the subject of this case, he is compelled to pass his hand completely into the vagina; and, from an anxiety to accomplish this, and to ascertain the nature of the presentation of the child, he is induced to repeat the operation very often. These repeated examinations are often productive of very serious mischief, causing inflammation, which frequently terminates in suppuration and sloughing. With these circumstances before us, we are of opinion that every unnecessary manoeuvre ought to be avoided, and that the practitioner should acquaint himself, as com¬ pletely as it is possible, with the nature of the case, before he with¬ draws his hand. Case II.—Mary Moron, aged 39, had been married sixteen years, and had been pregnant eight times, in seven of which she reached the full period of gestation, and in one she miscarried once at the fourth month, which happened about thirteen months before her present pregnancy. The last natural labour took place about four years since, and was so rapid, as to be completed in two to three hours. She had enjoyed good health until about two