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LOUISVILLE, KY.

as well.

Original Communications. beset with fibromata which would give

rise to the greatest danger and trouble

during pregnancy and delivery are the FIBROID TUMORS AND PREG

ones the least apt to become the seat of NANCY.

the fructified ovum, and in a considera

tion of the dangers which may arise BY LOUIS FRANK, M.D.,

during the course of pregnancy or at Professor of Abdominal Surgery and Gynecology in Kentucky University, Medical Department;

term, the location of the tumors, not Consultant and Visiting Surgeon to the only in their relation to the structure of Louisville City Hospital, etc., etc.

the uterus (its mucosa, muscularis and

peritoneum), but their relation to the To judge from text-book literature, fundus and body and cervix must be we would believe that pregnancy, com

borne in mind. The conditions met plicated by uterine fibroids or pregnan- with may require active surgical intercy in fibro-myomatous uteri, was a very vention, therefore these cases are of indangerous condition, not only to the terest not only to the obstetrician, but child, but also to the mother. We to the general practitioner and surgeon should remember, however, that the opinions expressed in standard text- I will not trouble you by a citation books have been based largely upon the

of the various localities which may be outcome of cases observed during the occupied by fibromatous tumors of the period of pre-antiseptic obstetrics and uterus, nor the various classifications of surgery, rather than upon present day these growths, except to say that statistics.

tumors occupying the lower portion of Again, as only the worst cases have the uterine segment, or occupying the been reported, or those in which in all sub-mucous structures, are to be classiprobability operative measures had fied as the most dangerous. The danbeen carried out, and that there has re- gers from these tumors, and the acci. mained unreported and unpublished dents which may occur, should be many cases in which no trouble was considered from the standpoint of the met with during or subsequent to the child as well as the mother. The danaccouchement, or in which the condition gers to the child are those due to prewas present and probably overlooked, mature labor, placenta previa, abnormal as is true in this as well as in other dis- presentation, Cæsarian section or other eases, it is not difficult to understand operative procedure which may become the conclusions which were arrived at. necessary for its delivery. The dan

That the condition is entirely free gers arising to the mother are from from danger no one would attempt to accidents which may occur, such as say, but my opinion is that this danger abortion, hemorrhage, sepsis due to is not nearly so great as we have been sloughing of the tumor from pressure, led to believe. Fortunately those uteri from rupture of the uterus, or op

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