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Stanley, Vanderveer, and Young cite instances of intrauterine fracture of the thigh; in the case of Stanley the fracture occurred during the last week of gestation, and there was rapid union of the fragments during lactation. Danyau, Proudfoot, and Smith mention intrauterine fracture of the tibia; in Proudfoot's case there was congenital talipes talus.
The head, chest, body, and male genitals were well formed, and the child survived. Hutchinson reports the history of a child born without extremities, probably the result of intrauterine amputation. The flaps were healed at the deltoid insertion and just below the groin. Pare says he saw in Paris a man without arms, who by means of his head and neck could crack a whip or hold an axe.
Montgomery, in an excellent paper, advances the theory, which is very plausible, that intrauterine amputations are caused by contraction of bands or membranes of organized lymph encircling the limb and producing amputation by the same process of disjunctive atrophy that the surgeons induce by ligature.
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.
The operation is quite simple and as follows: The husband, having been found perfectly healthy, is directed to cohabit with his wife, using a condom. The semen ejaculated is sucked up by an intrauterine syringe which has been properly disinfected and kept warm.
That the child had not had six months of intrauterine life he could vouch, the statement being borne out by the last menstrual period of the mother, the date of the first fetal movements, the child's weight, which was 30 1/2 ounces, and its appearance. Budin had had this infant under observation from the beginning and corroborated Villemin's statements.
Many well-authenticated cases of combined pregnancy, in which one of the products of conception was intrauterine and the other of extrauterine gestation, have been recorded. Clark and Ramsbotham report instances of double conception, one fetus being born alive in the ordinary manner and the other located extrauterine.
This descent of the testes from the abdomen takes place normally in the later weeks of intrauterine life. The testes may, however, through some unusual condition, be retained and make their descent months or even years later. If the testes have not descended by the end of the age of puberty, the advice of a competent surgeon should be sought.
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