One of the commonest conditions met with in ovariotomy during pregnancy and labour is to find that the cyst has undergone axial rotation and twisted its pedicle. The technique in these circumstances is very simple.
Ovariotomy for Tumours obstructing Labour at Term
| Operator. | Nature of Tumour. | Result to Mother. | Fate of Child. | Reference. |
|---|---|---|---|---|
| Williams | Cyst | R. | No record | Trans. Obstet. Soc., xxvi. 203. |
| Spencer | Dermoid | R. | Lived | Ibid., xl. 14. |
| Boxall 1 | Dermoid | R. | Lived | Ibid., xl. 25. |
| Bland-Sutton 1 | Dermoid | R. | Lived | Lancet, 1901, i. 382. |
| Sinclair 1 | Cyst | R. | Lived | Lancet, 1901, i. 158. |
| Favell 1 | Dermoid | R. | No record | Brit. Med. Journal, 1901, i. 894. |
1 In these cases it was necessary to perform Cæsarean section in order to extract the tumour from the pelvis.
Fig. 22. A Uterus distorted by Fibroids. It contains a fœtus of four months’ development. Removed by the subtotal operation from a primigravida, aged 42. Half size.
Ovariotomy during the puerperium. It occasionally happens that a woman may go through her pregnancy and labour with an unrecognized ovarian tumour in her abdomen; during the puerperal period it may cause symptoms which lead to its recognition, because in the course of the labour the cyst may burst, undergo axial rotation, or suppurate. When a puerperal woman possesses an ovarian tumour which gives rise to unfavourable signs, ovariotomy should be resorted to without delay. The operation in these circumstances is comparatively simple, and such adhesions as may be present are usually recent and easily overcome.
Single and even double ovariotomy can be performed during puerpery without in any way interfering with involution of the uterus or lactation.
In 1896 I was able to collect fifteen recorded cases of double ovariotomy during pregnancy, and sixteen in which ovariotomy was performed during the puerperium, or shortly after abortion. Since this date McKerron has collected the statistics relating to the whole question of pregnancy and ovarian tumours in a very comprehensive manner.