CASE REPORT OF OBSTRUCTED LABOR AND CASAREAN 
SECTION * 
By R. B. Woopwarp 
(Surgeon, United States Navy) 
The following history is of interest as emphasizing the danger 
of ventral fixation of the uterus in child-bearing women. 
Mrs. C., multipara, a short, heavy-set woman, 32: years of 
age. She has had 2 previous labors, both instrumental; one 
child, delivered by high foreeps in 1911, is living. 
She had conceived in-November, 1913, and came for exam- 
ination in March, 1914, stating that she had been told that 
another pregnancy would kill her. Examination revealed a 
large rectocele and an extreme dilation of the hemorrhoidal 
veins; the cervix, while high and slightly retroflexed, was in 
fair position. A large abdominal scar, due to a ventral fix- 
ation of the uterus in 1912, accounted for the high position of 
the cervix. The dangers of delivery at term were explained to 
the patient, who, however, being a devout Catholic, refused any 
interference at this time. Pregnancy proceeded normally, and 
September 4 was predicted as the date of beginning labor. The 
patient had false pains a week previous to this, and was much 
alarmed and worried over the onset of true labor. On the 
evening of September 8, at 10.45, the patient started on true 
labor; the os was dilated to admit 2 fingers, and pains came at 
eight-minute intervals, lasting from one to two minutes. Pro- 
gress in dilatation was steady but slow, and the presentation 
was an O. D. P. At 5 o'clock in the morning the os would 
admit 3 fingers, and the fixation of the uterus would not permit 
the cervix to descend or the head properly to engage. Pressure 
on the fundus was maintained, and under primary anesthesia 
digital dilatation of the cervix was attempted with no result. 
At 7.30 in the morning, under ether anethesia, high forceps was 
tried and an honest effort lasting fifty-five minutes was made 
to induce progress. None was made, and under the same 
anesthesia the patient was conveyed to the hospital and a Sanger 
*Read at the annual meeting of the Philippine Islands Medical Associa- 
tion, Manila, November 4~7, 1914. E 
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