Ascites of the Fetus 739 



cribriform plates of the ethmoid bone, which allowed the escape 

 of the fluid through the mouth, and the collapse of the pouch. 



2. Ascites and Hydrothorax. 



The peritoneal cavity of the fetus is occasionally the seat of 

 very extensive effusions. It is said that in some rare cases the 

 pleural cavity may suffer similarly. The causes of fetal ascites 

 are unknown. Possibly some cases designated as ascites are due to 

 cystic distension of the fetal kidneys, ovaries or other organs. 



The symptoms of ascites, and similarly of hydrothorax, are 

 confined to the resultant dystokia. It occurs almost wholly in 

 the calf. Upon examination it may be found that the fetus is pre- 

 senting normally, and the advancing parts are of normal form 

 and volume. If presenting anteriorly, there is no apparent ob- 

 stacle to expulsion until the head and neck have passed the 

 vulva, when progress ceases, and, although considerable traction 

 may be applied, the fetus appears immovable. 



Upon examination the veterinarian finds that the abdomen is 

 enormously enlarged, tense and fluctuating, and alone consti- 

 tutes the obstacle to parturition. 



When the fetus presents posteriorly the symptoms are quite 

 analogous ; the fetus in normal attitude advances until the hips 

 enter the pelvic canal, where it stops. Inserting the hand along- 

 side the fetal body, the distended abdomen may be felt and 

 recognized. 



The handling of the dystokia consists fundamentally of re- 

 leasing the fluid from the abdominal cavity. This may be done 

 in a variety of ways. The operator may carry a finger-knife or 

 concealed scalpel into the uterine cavity, and incise the abdomen 

 of the fetus from without, thus allowing the fluid to escape into 

 the uterine cavity of the mother. 



From the standpoint of safety to the mother and convenience 

 to the operator, we prefer liberating the fluid through the chest 

 cavity externally. The head and neck have already passed the 

 vulva ; it is the work of but a few minutes to remove one an- 

 terior limb subcutaneously, as described on page 645; after 

 which one or two of the exposed fetal ribs may be severed. The 

 operator can then eviscerate, page 658, pass his hand through 

 the chest cavity, and rupture the diaphragm, when the ascitic 



