Malignant and other Newgrowths 691 



The prognosis is highly unfavorable if the tumor is malignant 

 because, although it may be possible to deliver the fetus, the life 

 of the mother cannot usually be greatly prolonged, and the disease 

 itself is generally beyond remedy. The disturbance of parturi- 

 tion is quite inclined to arouse the disease process to renewed 

 activity. 



Should the tumor be of a benign character, and its anatomical 

 relations permit removal, the prognosis is favorable. 



The handling of the dystokia is to be based upon the char- 

 acter of the tumor. If malignant, the chief aim should be the 

 saving of the life of the fetus, if of value. Partial or complete 

 removal of a mahgnant tumor of the genital canal may be war- 

 ranted in order to remove the obstruction to birth, and the fetus 

 may then be delivered through the birth canal. If the tumor is 

 irremovable and offers serious obstacle to delivery, gastro-hyster- 

 otomy may be performed to save the life of the young. 



Benign tumors interfering with parturition should be removed. 



Numerous other minor impediments to parturition occur very 

 rarely in the genital canal. 



Adhesions and constrictions in the vulvo- vaginal canal offer 

 at times more or less serious impediments to parturition, which 

 may lead to important lacerations of the soft parts. 



Persistent hymen is occasionally met with in cases of dys- 

 tokia, but, so far as we have observed, consists of thin bands, 

 stretching from floor to roof between vulva and vagina but taking 

 no part in the causation of the dystokia. They are easily 

 ruptured with the fingers. 



