Campbell relates that Brewis, in performing an ovariotomy during pregnancy, attempted to conserve some ovarian tissue by resecting the dermoids; this proved impracticable, and both ovaries were excised. Miss Ivens records a case in which a woman thirty-five years of age was five months pregnant and required ovariotomy on account of an incarcerated ovarian dermoid. In the course of the operation both ovaries were found to contain dermoids. A tumour was successfully excised from each. Pregnancy continued undisturbed.
References
Campbell, M. Case of Bilateral Ovarian Dermoid Tumour associated with Pregnancy. Lancet, 1907, ii. 1760.
Cullingworth, C. J. Three cases of Suppurating Dermoid Cyst, of or near the Ovary, treated by Abdominal Section. St. Thomas’s Hospital Reports, 1887–9, xvii. 139.
Hart, Berry. See Clarence Webster’s Researches in Female Pelvic Anatomy, Edin., 1892, p. 124.
Ivens, Miss F. Pregnancy complicated by Bilateral Ovarian Dermoid Cysts. Brit. Med. Journal, 1908, i. 625.
Page, F. Acute Peritonitis after Confinement; abdominal section; Dermoid Disease of both Ovaries; removal; recovery. Lancet, 1893, ii. 250.
Thornton, K. A case of removal of both Ovaries during Pregnancy. Trans. Obstet. Soc., London, xxviii. 41.
Ovariotomy during labour. When an ovarian tumour is discovered during labour and it impedes delivery, ovariotomy should be performed.
In this condition it follows that the tumour lies in the pelvis; when the tumour is tightly impacted by the contracting uterus it has happened that the surgeon has been unable to reach the tumour until he has emptied the uterus by Cæsarean section. Several operators have had this difficulty, myself among them. I have added a list of reported cases drawn from British sources. For this I hope not to be accused of what is sometimes perhaps facetiously called ‘insularity’. The enormous population of these islands should furnish material enough to settle the principles of treatment which should govern these terrible cases of obstructed labour.