Long Retention of Extrauterine Pregnancy

Anomalies and Curiosities of Medicine
by George M. Gould, M.D., Walter L. Pyle, M.D.

(Page 6 of 39)

The time of the retention of an extrauterine gestation is sometimes remarkable, and it is no uncommon occurrence for several pregnancies to successfully ensue during such retention. The Ephemerides contains examples of extrauterine pregnancy remaining in the abdomen forty-six years; Hannaeus mentioned an instance remaining ten years, the mother being pregnant in the meantime; Primperosius speaks of a similar instance; de Blegny, one of twenty-five years in the abdomen; Birch, a case of eighteen years in the abdomen, the woman bearing in the meantime; Bayle, one of twenty-six years, and the Ephemerides, another. In a woman of forty-six, the labor pains intervened without expulsion of the fetus. Impregnation ensued twice afterward, each followed by the birth of a living child. The woman lived to be ninety-four, and was persuaded that the fetus was still in the abdomen, and directed a postmortem examination to be made after her decease, which was done, and a large cyst containing an ossified fetus was discovered in the left side of the cavity. In 1716 a woman of Joigny when thirty years old, having been married four years, became pregnant, and three months later felt movements and found milk in her breasts. At the ninth month she had labor-pains, but the fetus failed to present; the pains ceased, but recurred in a month, still with a negative result. She fell into a most sickly condition and remained so for eighteen months, when the pains returned again, but soon ceased. Menstruation ceased and the milk in her breasts remained for thirty years. She died at sixty-one of peripneumonia, and on postmortem examination a tumor was found occupying part of the hypogastric and umbilical regions. It weighed eight pounds and consisted of a male fetus of full term with six teeth; it had no odor and its sac contained no liquid. The bones seemed better developed than ordinarily; the skin was thick, callous, and yellowish The chorion, amnion, and placenta were ossified and the cord dried up. Walther mentions the case of an infant which remained almost petrified in the belly of its mother for twenty-three years. No trace of the placenta, cord, or enveloping membrane could be found.

Cordier publishes a paper on ectopic gestation, with particular reference to tubal pregnancy, and mentions that when there is rupture between the broad ligaments hemorrhage is greatly limited by the resistance of the surrounding structures, death rarely resulting from the primary rupture in this location. Cordier gives an instance in which he successfully removed a full-grown child, the result of an ectopic gestation which had ruptured intraligamentally and had been retained nearly two years.

Lospichlerus gives an account of a mother carrying twins, extrauterine, for six years. Mounsey of Riga, physician to the army of the Czarina, sent to the Royal Society in 1748 the bones of a fetus that had been extracted from one of the fallopian tubes after a lodgment of thirteen years. Starkey Middleton read the report of a case of a child which had been taken out of the abdomen, having lain there nearly sixteen years, during which time the mother had borne four children. It was argued at this time that boys were conceived on the right side and girls on the left, and in commenting on this Middleton remarks that in this case the woman had three boys and one girl after the right fallopian tube had lost its function. Chester cites the instance of a fetus being retained fifty-two years, the mother not dying until her eightieth year. Margaret Mathew carried a child weighing eight pounds in her abdomen for twenty-six years, and which after death was extracted. Aubrey speaks of a woman aged seventy years unconsciously carrying an extrauterine fetus for many years, which was only discovered postmortem. She had ceased to menstruate at forty and had borne a child at twenty-seven. Watkins speaks of a fetus being retained forty-three years; James, others for twenty-five, thirty, forty-six, and fifty years; Murfee, fifty-five years; Cunningham, forty years; Johnson, forty-four years; Josephi, fifteen years (in the urinary bladder); Craddock, twenty-two years, and da Costa Simoes, twenty-six years.

Long Retention of Uterine Pregnancy. - Cases of long retained intrauterine pregnancies are on record and deserve as much consideration as those that were extrauterine. Albosius speaks of a mother carrying a child in an ossified condition in the uterus for twenty-eight years. Cheselden speaks of a case in which a child was carried many years in the uterus, being converted into a clay-like substance, but preserving form and outline. Caldwell mentions the case of a woman who carried an ossified fetus in her uterus for sixty years. Camerer describes the retention of a fetus in the uterus for forty-six years; Stengel, one for ten years, and Storer and Buzzell, for twenty-two months. Hannaeus, in 1686, issued a paper on such a case under the title, "Mater, Infantis Mortui Vivum Sepulchrum," which may be found in French translation.

Buchner speaks of a fetus being retained in the uterus for six years, and Horstius relates a similar case. Schmidt's Jahrbucher contain the report of a woman of forty-nine, who had borne two children. While threshing corn she felt violent pain like that of labor, and after an illness suffered a constant fetid discharge from the vagina for eleven years, fetal bones being discharged with occasional pain. This poor creature worked along for eleven years, at the end of which time she was forced to bed, and died of symptoms of purulent peritonitis. At the necropsy the uterus was found adherent to the anterior wall of the abdomen and containing remnants of a putrid fetus with its numerous bones. There is an instance recorded of the death of a fetus occurring near term, its retention and subsequent discharge being through a spontaneous opening in the abdominal wall one or two months after.

Meigs cites the case of a woman who dated her pregnancy from March, 1848, and which proceeded normally for nine months, but no labor supervened at this time and the menses reappeared. In March, 1849, she passed a few fetal bones by the rectum, and in May, 1855, she died. At the necropsy the uterus was found to contain the remains of a fully developed fetus, minus the portions discharged through a fistulous connection between the uterine cavity and the rectum. In this case there had been retention of a fully developed fetus for nine years. Cox describes the case of a woman who was pregnant seven months, and who was seized with convulsions; the supposed labor-pains passed off, and after death the fetus was found in the womb, having lain there for five years. She had an early return of the menses, and these recurred regularly for four years. Dewees quotes two cases, in one of which the child was carried twenty months in the uterus; in the other, the mother was still living two years and five months after fecundation. Another case was in a woman of sixty, who had conceived at twenty-six, and whose fetus was found, partly ossified, in the uterus after death.

There are many narratives of the long continuation of fetal movements, and during recent years, in the Southern States, there was quite a prevalence of this kind of imposters. Many instances of the exhibition of fetal movements in the bellies of old negro women have been noticed by the lay journals, but investigation proves them to have been nothing more than an exceptional control over the abdominal muscles, with the ability to simulate at will the supposed fetal jerks. One old woman went so far as to show the fetus dancing to the music of a banjo with rhythmical movements. Such imposters flourished best in the regions given to "voodooism." We can readily believe how easy the deception might be when we recall the exact simulation of the fetal movements in instances of pseudocyesis.

The extraordinary diversity of reports concerning the duration of pregnancy has made this a much mooted question. Many opinions relative to the longest and shortest period of pregnancy, associated with viability of the issue, have been expressed by authors on medical jurisprudence. There is perhaps no information more unsatisfactory or uncertain. Mistakes are so easily made in the date of the occurrence of pregnancy, or in the date of conception, that in the remarkable cases we can hardly accept the propositions as worthy evidence unless associated with other and more convincing facts, such as the appearance and stage of development of the fetus, or circumstances making conception impossible before or after the time mentioned, etc. It will be our endeavor to cite the more seemingly reliable instances of the anomalies of the time or duration of pregnancy reported in reputable periodicals or books.