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At least 19 recordsLinked to original sources

[Ethics of medical management of inability to give birth. Johannes Stahelin and his plea for embryotomy].

Confronted with the inability to give birth to a child, delivery could be achieved by embryotomy--that was only permitted, when the foetus was dead--or by Caesarean section--where the chance to save mother and child as well was merely theoretical until the end of the 19th century. In two statements of the Theological Faculty of the Sorbonne in Paris embryotomy was absolutely rejected (1648), in nearly all cases of impossible delivery the Caesarean section was required (1733). In 1749 Johannes Stähelin starts a daring attempt to justify embryotomy by application of natural law to the situation of critical childbirth. Keywords of the theological statements are confronted with categories of the natural law in a sophisticated way, nevertheless the basis of Christian confession is maintained. This argumentation in order to justify embryotomy as a lawful method to deliver a woman seemed to be more adequate to the medical sphere than claiming the Caesarean section. The ethical debate continued until the problem was solved by mastering Caesarean section.

Abortion, Induced↗

[Embryotomy. A historical review].

Destructive operations are the oldest type of bloody operation in obstetrics and possibly in the (written) history of Medicine. The name "embryotomy" is already mentioned in the hippocratic literature. The indication and technique of this "two-tempi" operation (embryotomy or reduction of the fetus and embryulcia or extraction of the reduced foetus) were thoroughly mentioned, described and coded for the first time by Soranos of Ephesos. Soranos was also the first to mention clearly by their names the instruments used. Only the Arabic physicians, especially Albucasim, transmitted to us the first image of their collection of instruments. The author elucidates the many--medical and ethical--aspects relating to embryotomy, which has been practised till after W.W.II.

Abortion, Induced↗

A tragic case of complicated labour in early Byzantium (404 A.D.).

OBJECTIVES: Presentation and comment on the problematic delivery of the Byzantine empress Eudoxia's stillborn child. STUDY DESIGN: The original Greek language Byzantine histories, chronicles and hagiographical sources were investigated. Comparisons were then made of the knowledge of obstetrics among contemporary and ancient physicians. RESULTS: The case of Eudoxia's delivery is described in various literary sources with details regarding the fatal clinical picture of the parturient after the embryo's death. The study of early and contemporary medical texts proves that in similar cases conservative treatment was preferred but embryotomy was followed in the event of failure. CONCLUSIONS: Eudoxia's labour represents a characteristic paradigm of the difficulties involved in the confrontation of complicated deliveries in mediaeval times, often resulting in the death of both the mother and embryo. The treatments follow the ancient Hippocratic, Hellenistic and Roman traditions and influence medieval European medicine, thus constituting significant roots of obstetrics.

Byzantium↗

Fetal ascites. A report of 3 autopsy cases.

Three rare autopsy cases of fetal ascites were presented and the etiology of each case was described. Case 1 was a male neonate, delivered by cesarean section at 32 weeks' gestation, and died of respiratory failure. The abdomen was remarkably distended with 1020 ml of ascites. The etiology of Case 1 remained unknown even after macroscopic and microscopic examinations. We considered this as "idiopathic" fetal ascites. Case 2 was a female neonate, delivered at 31 weeks' gestation, with marked abdominal distension and cyanosis. Autopsy revealed 435 ml of ascites, and she was considered to have had "polysplenia syndrome" with cardiovascular malformations. Intrauterine heart failure due to cardiac anomalies was thought to be the cause of this ascites. In case 3 embryotomy was carried out under the diagnosis of fetal ascites by ultrasound examination at 22 weeks' gestation. An urachal cyst connected to the dilated urinary bladder and deficiency of musculature of the abdominal wall composed of loose connective tissue with calcification were observed. The abdominal wall was ruptured and 1,960 ml of ascites was measured. Polycystic kidney with renal dysplasia was also found. Case 3 showed "Prune-Berry syndrome" and fetal ascites may have arisen from these anomalies.

Abortion, Induced↗