It is now ten years ago since we first surmised that "the reason why
labour usually terminates pregnancy at the 40th week is from the
recurrence of a menstrual period at a time during pregnancy when the
uterus, from its distension and weight of contents, is no longer able to
bear that increase of irritability which accompanies these periods without
being excited to throw off the ovum."
Under the head of PREMATURE EXPULSION, we shall have occasion to notice
the disposition to abortion which the uterus evinces at what, in the
unimpregnated state, would have been a menstrual period: for some months
after the commencement of pregnancy, a careful observer may distinctly
trace the periodical symptoms of uterine excitement coming on at certain
intervals, and it may be easily supposed that many causes for abortion act
with increased effect at these times. Where the patient has suffered from
dysmenorrhoea before pregnancy, these periods continue to be marked with
such an increase of uterine irritability as to render them for some time
exceedingly dangerous to the safety of the ovum. Even to a late period of
gestation, the uterus continues to indicate a slight increase of
irritability at these periods, although much more indistinctly; thus, in
cases of hæmorrhage before labour, especially where it arises from the
attachment of the placenta to the os uteri, it is usually observed to come
on, and to return, at what in the unimpregnated state would have been a
menstrual period. We mention these facts as illustrating what we presume
are the laws on which the duration of pregnancy depends, and also as being
capable of affording a satisfactory explanation of those seeming over-term
cases which are occasionally met with.
From this view of the subject it will be evident, that the period of the
menstrual interval at which conception takes place, will in great measure
influence the duration of the pregnancy afterwards; that where it has
occurred immediately after an appearance of the menses, the uterus will
have attained such a dilatation and weight of contents by the time the
ninth period has arrived, that it will not be able to pass through this
state of catamenial excitement without contraction, or, in other words,
labour coming on: hence it is that we find a considerable number of
labours fall short of the usual time, so much so that some authors have
even considered the natural term of human gestation to be 273 days or 39
weeks: for a somewhat similar reason we can explain why primiparæ seldom
go quite to the full term of gestation, the uterus being less capable of
undergoing the necessary increase of volume in a first pregnancy than it
is in succeeding ones.
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