7o6 Veternary Obstetrics 



largely upon the duration and extent of the lesion. When a re- 

 cent torsion, to the extent of ^ to )^ of a revolution, exists, it is 

 ordinarily not to be regarded as serious, because it may not 

 greatly imperil the life of the fetus, or render its extraction a for- 

 midable matter. It may not interfere very greatly with the cir- 

 culation in the uterus or with the nutrition of the uterus and 

 fetus. When, however, the torsion becomes complete, as in Fig. 

 ii6, or there is almost a complete turn upon its long axis, the 

 circulation of the organ is at once seriously interrupted. Unless 

 prompt relief is afforded, the fetus must perish, and almost cer- 

 tainly undergo decomposition with all its consequences, and the 

 uterus must become seriously diseased. If the twist proceeds a 

 step further, a rupture of the uterus results, which must almost 

 inevitably lead to the death of the animal ; or should she survive, 

 her value is usually destroyed because of the very slow, uncertain, 

 and imperfect recovery, by the sloughing of the fetus through 

 the abdominal walls or into the alimentary canal. 



The prognosis must therefore always be very cautiously made. 



1. The torsion may be reducible or irreducible. 



2. The fetus may be alive, or dead and emphysematous, ac- 

 cording to the duration and extent of the torsion. 



3. The putrid decomposition of the fetus and the serious dis- 

 turbances in the circulation may have led to uterine paralysis, 

 inflammation or gangrene from which it is impossible for the 

 animal to recover. 



4. The uterus may have suffered a fatal transverse rupture, 

 which may not reveal itself until after the torsion has been 

 reduced and the fetus extracted. 



Treatment. The handling of torsion of the uterus must be 

 based upon the extent and duration of the condition and the 

 character of the pathologic changes which have occurred. 



I. In slight torsion, where the uterus has not made a complete 

 revolution upon its long axis, it may be possible to advance the 

 hand through the vagina and cervical canal into the uterus, 

 rupture the fetal membranes, seize the presenting limbs, and, 

 by exerting force upon the fetus itsejf, cause the uterus to 

 turn back to its normal position. In such a case the force 

 is to be exerted in the direction opposite to the twist, 

 turning the organ back to its original position. If the tor- 

 sion has taken place to the right, the force, exerted indirectly 



