Page:Clinical Lectures on the Diseases of Women.djvu/17

 labour or missed abortion. This subject is of great medico- legal importance, as I shall show you presently.

Let me first give you the particulars of a remarkable case of protracted pregnancy and missed labour, which occurred in my private practice, and. which forms a good illustration of these morbid conditions. The lady was forty-one years of age when she became pregnant for the first time. The uterus was, from the earliest time after its ascent into the abdomen, anteverted or pendulous. It was not the common form of pendulous belly, which can be replaced by bandage and held up j it could not be replaced. This impossibility of replacement was also observed during her confinement; and there was no reason to believe that there were any adhesions of the uterus. Her pregnancy up to the end of the natural term was otherwise perfectly healthy. She had a slight degree of generally contracted pelvis. Before giving you the dates I may tell you that none, in the most careful ordinary life, could be more accurately ascertained or more reliable than those I now state. Her menses ended on December 12. On December 15 her husband left home, and did not return for nearly two months. Her confine- ment was expected on September 17. The motion of the child ceased on September 26. On October 17 she shivered and became feverish without any indication of labour com- mencing. It was considered necessary to deliver her. The mouth of the womb was artificially dilated, and she was artificially delivered on the following day, October 18. The child was enormous — a female, dead. The mother died on October 2 1. This is a case in which you have, with almost scientific certainty, slight protraction of pregnancy, and then the condition of missed labour. After a foetus's deatli under any circumstances it is generally discharged within a fort- night. In this case more than a fortnight elapsed after the tion of movements, and there were never any symptoms of labour.