John Michaels

Combined extrauterine and intrauterine pregnancy

Abstract 1. 1. Four new instances of combined extrauterine and intrauterine pregnancy are reported. 2. 2. The ratio of coexistent ectopic intrauterine pregnancy to ectopic pregnancy at the Charity Hospital during the last ten years is approximately 1 to 100. 3. 3. At the time of operation for an ectopic gestation, one case (Case 1) was correctly diagnosed as a combined pregnancy and in one case (Case 2) this condition merely suspected. In both cases the corpus luteum was unfortunately sacrified. Case 1 continued to term, and a living child was delivered by cesarean section, while Case 2 aborted twenty-four days postoperatively. In such instances, substitution hormonal therapy should be instigated and maintained at least to the twenty-fourth week. 4. 4. In approximately 25 per cent of the reported cases in the literature, one or occasionally both fetuses continued to term. 5. 5. The reported maternal mortality is high. The following factors should materially aid in its reduction: 1. A. More widespread use of cul-de-sac puncture as an aid in the early diagnosis of ruptured ectopic pregnancy. 2. B. Avoidance of removal of the placenta of the abdominal twin. 3. C. Liberal and prompt use of whole blood and plasma in the emergency stages.

Successful removal of a 71 pound papillary serous cystadenoma of the ovary

Abstract A case of a 71 pound papillary cystadenoma of the ovary is reported. It was removed with some difficulty, but successfully. When last seen fourteen months after surgery, the patient was in excellent health for her age of 63 years.