There are some marvelous cases of recovery and noninterference with pregnancy after injuries from horns of cattle. Corey speaks of a woman of thirty-five, three months pregnant, weighing 135 pounds, who was horned by a cow through the abdominal parietes near the hypogastric region; she was lifted into the air, carried, and tossed on the ground by the infuriated animal. There was a wound consisting of a ragged rent from above the os pubis, extending obliquely to the left and upward, through which protruded the great omentum, the descending and transverse colon, most of the small intestines, as well as the pyloric extremity of the stomach. The great omentum was mangled and comminuted, and bore two lacerations of two inches each. The intestines and stomach were not injured, but there was considerable extravasation of blood into the abdominal cavity. The intestines were cleansed and an unsuccessful attempt was made to replace them. The intestines remained outside of the body for two hours, and the great omentum was carefully spread out over the chest to prevent interference with the efforts to return the intestines. The patient remained conscious and calm throughout; finally deep anesthesia was produced by ether and chloroform, three and a half hours after the accident, and in twenty minutes the intestines were all replaced in the abdominal cavity. The edges were pared, sutured, and the wound dressed. The woman was placed in bed, on the right side, and morphin was administered. The sutures were removed on the ninth day, and the wound had healed except at the point of penetration. The woman was discharged twenty days after, and, incredible to relate, was delivered of a well-developed, full-term child just two hundred and two days from the time of the accident. Both the mother and child did well.
Luce speaks of a pregnant woman who was horned in the lower part of the abdomen by a cow, and had a subsequent protrusion of the intestines through the wound. After some minor complications, the wound healed fourteen weeks after the accident, and the woman was confined in natural labor of a healthy, vigorous child. In this case no blood was found on the cow's horn, and the clothing was not torn, so that the wound must have been made by the side of the horn striking the greatly distended abdomen.
Richard, quoted also by Tiffany, speaks of a woman, twenty-two, who fell in a dark cellar with some empty bottles in her hand, suffering a wound in the abdomen 2 inches above the navel on the left side 8 cm. long. Through this wound a mass of intestines, the size of a man's head, protruded. Both the mother and the child made a good convalescence. Harris cites the instance of a woman of thirty, a multipara, six months pregnant, who was gored by a cow; her intestines and omentum protruded through the rip and the uterus was bruised. There was rapid recovery and delivery at term. Wetmore of Illinois saw a woman who in the summer of 1860, when about six months pregnant, was gored by a cow, and the large intestine and the omentum protruded through the wound. Three hours after the injury she was found swathed in rags wet with a compound solution of whiskey and camphor, with a decoction of tobacco. The intestines were cold to the touch and dirty, but were washed and replaced. The abdomen was sewed up with a darning needle and black linen thread; the woman recovered and bore a healthy child at the full maturity of her gestation. Crowdace speaks of a female pauper, six months pregnant, who was attacked by a buffalo, and suffered a wound about 1½ inch long and ½ inch wide just above the umbilicus. Through this small opening 19 inches of intestine protruded. The woman recovered, and the fetal heart-beats could be readily auscultated.
Major accidents in pregnant women are often followed by the happiest results. There seems to be no limit to what the pregnant uterus can successfully endure. Tiffany, who has collected some statistics on this subject, as well as on operations successfully performed during pregnancy, which will be considered later, quotes the account of a woman of twenty-seven, eight months pregnant, who was almost buried under a clay wall. She received terrible wounds about the head, 32 sutures being used in this location alone. Subsequently she was confined, easily bore a perfectly normal female child, and both did well. Sibois describes the case of a woman weighing 190 pounds, who fell on her head from the top of a wall from 10 to 12 feet high. For several hours she exhibited symptoms of fracture of the base of the skull, and the case was so diagnosed; fourteen hours after the accident she was perfectly conscious and suffered terrible pain about the head, neck, and shoulders. Two days later an ovum of about twenty days was expelled, and seven months after she was delivered of a healthy boy weighing 10½ pounds. She had therefore lost after the accident one-half of a double conception.
Verrier has collected the results of traumatism during pregnancy, and summarizes 61 cases. Prowzowsky cites the instance of a patient in the eighth month of her first pregnancy who was wounded by many pieces of lead pipe fired from a gun but a few feet distant. Neither the patient nor the child suffered materially from the accident, and gestation proceeded; the child died on the fourth day after birth without apparent cause. Milner records an instance of remarkable tolerance of injury in a pregnant woman. During her six months of pregnancy the patient was accidentally shot through the abdominal cavity and lower part of the thorax. The missile penetrated the central tendon of the diaphragm and lodged in the lung. The injury was limited by localized pneumonia and peritonitis, and the wound was drained through the lung by free expectoration. Recovery ensued, the patient giving birth to a healthy child sixteen weeks later. Belin mentions a stab-wound in a pregnant woman from which a considerable portion of the epiploon protruded. Sloughing ensued, but the patient made a good recovery, gestation not being interrupted. Fancon describes the case of a woman who had an injury to the knee requiring drainage. She was attacked by erysipelas, which spread over the whole body with the exception of the head and neck; yet her pregnancy was uninterrupted and recovery ensued. Fancon also speaks of a girl of nineteen, frightened by her lover, who threatened to stab her, who jumped from a second-story window. For three days after the fall she had a slight bloody flow from the vulva. Although she was six months pregnant there was no interruption of the normal course of gestation.
Bancroft speaks of a woman who, being mistaken for a burglar, was shot by her husband with a 44-caliber bullet. The missile entered the second and third ribs an inch from the sternum, passed through the right lung, and escaped at the inferior angle of the scapula, about three inches below the spine; after leaving her body it went through a pine door. She suffered much hemorrhage and shock, but made a fair recovery at the end of four weeks, though pregnant with her first child at the seventh month. At full term she was delivered by foot-presentation of a healthy boy. The mother at the time of report was healthy and free from cough, and was nursing her babe, which was strong and bright.
All the cases do not have as happy an issue as most of the foregoing ones, though in some the results are not so bad as might be expected. A German female, thirty-six, while in the sixth month of pregnancy, fell and struck her abdomen on a tub. She was delivered of a normal living child, with the exception that the helix of the left ear was pushed anteriorly, and had, in its middle, a deep incision, which also traversed the antihelix and the tragus, and continued over the cheek toward the nose, where it terminated. The external auditory meatus was obliterated. Gurlt speaks of a woman, seven months pregnant, who fell from the top of a ladder, subsequently losing some blood and water from the vagina. She had also persistent pains in the belly, but there was no deterioration of general health. At her confinement, which was normal, a strong boy was born, wanting the arm below the middle, at which point a white bone protruded. The wound healed and the separated arm came away after birth. Wainwright relates the instance of a woman of forty, who when six months pregnant was run over by railway cars. After a double amputation of the legs she miscarried and made a good recovery. Neugebauer reported the history of a case of a woman who, while near her term of pregnancy, committed suicide by jumping from a window. She ruptured her uterus, and a dead child with a fracture of the parietal bone was found in the abdominal cavity. Staples speaks of a Swede of twenty-eight, of Minnesota, who was accidentally shot by a young man riding by her side in a wagon. The ball entered the abdomen two inches above the crest of the right ilium, a little to the rear of the anterior superior spinous process, and took a downward and forward course. A little shock was felt but no serious symptoms followed. In forty hours there was delivery of a dead child with a bullet in its abdomen. Labor was normal and the internal recovery