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A new method of diagnosing rupture of the membranes
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AMERICAN ,JOURNAL 01<' OBSTETRICS AND GYNECOLOGY
v. Numers, C.: A New Method of Diagnosing Rupture of the Membranes, Acta Obst. et gynec. Scandinav. 16: 249, 1936. For the purpose of diagnosing rupture of the membranes in the eourse of labor, the writer attempted, by means of Sudan staining, to prove the oceurrence in the vaginal seeretion of free drops of fat or expelled cells of the fetal Rebaceous gland~ derived from vernix caseosa. Through a glass speculum one drop of secretion i;; taken with a platinum loop and spread out on a carefully defatted slide. ThP preparation is air·dried and stained at room temperature in a dye solution, 0.2 to 0.3 gm. Sudan III in 100 c.c. of 70 per cent hot alcohol. The slide is washed in water, dried and examined immediately under low magnifying power. The fat substances are stained a distinct orange red; particles of mucus are sometimes stained weakl.v yellowish red. Of 141 samples taken before rupture of the membranes only 4 gave a slight positive Sudan reaction, the rest yielding a negative result (97.2 pt>r eent). Of the 139 samples taken after rupture only one gave a negative reaction. Slight Sudan reactions seem to be relatively more frequent in premature case~. The faulty reactions amount to about 2 per cent of the entire material.
,T. P.
GREENHILL.
Endres, P.: Does Premature or Early Rupture of the Membranes Influence the Length of Labor, Monatschr. f. Geburtsh. u. Gyniik. 105: 216, 1937.
Contrary to the general belief, Endres found that premature rupture of the membranes before the onset of labor shortened labor. This was true even when pregnancy was terminated prematurely or postmaturely. The shortening of labor takes place during the first stage. Renee the absence of the bag of waters not only does not influence the period of dilatation unfavorably, but it actually helps dilatation in many cases. The reason for this, in the opinion of the author, is the absence of resistance which is present when hydrostatic pressure is exerted by an intact bag of waters. On the other hand, rupture of the membranes after the onset of labor pains but before complete dilatation of the cervix, prolonged labor. In these cases the increase in labor is due to a prolonged first stage. The cause for this is a temporary atony of the uterus which follows rupture of the membranes. The practical significance of these findings is that premature rupture of the membranes is a justifiable procedure in certain cases. Above all, when premature rupture occurs spontaneously, drugs should not be given to hasten labor pains because they may have a detrimental effect. J. P. GREENHILL. Reiles: Induction of Labor in Cases of Premature Rupture of the Membranes, Bull. Soc. d 'obst. et de gynec. 25: 337, 1936. Reiles employs the Stein method of inducing labor. In a series of 7(1 cases labor was successfully induced in 64, i.e., in 84.2 per cent. In all the cases where labor was not induced the cervix was long anu uneffaced. The average duration of labor in the successful cases with spontaneous deliveries was eight hours anrl forty·eight Ininutes fur the printipara~ and four- hout~ lor the rnult.ipa~as. :i{o harm to the baby was observed.
J. P.
GREENHif,L.
Sunde, A.: Spontaneous and Artificial Rupture of the Membranes During Labor, Acta obst. et gynec. Scandinav. 17: 133, 1937. In 9,375 full-term labor cases observed at the Oslo Woman's Clinic, the time of rupture of the bag of waters was known. The author found that rupture of
AMERICAN ,JOURNAL 01<' OBSTETRICS AND GYNECOLOGY
v. Numers, C.: A New Method of Diagnosing Rupture of the Membranes, Acta Obst. et gynec. Scandinav. 16: 249, 1936. For the purpose of diagnosing rupture of the membranes in the eourse of labor, the writer attempted, by means of Sudan staining, to prove the oceurrence in the vaginal seeretion of free drops of fat or expelled cells of the fetal Rebaceous gland~ derived from vernix caseosa. Through a glass speculum one drop of secretion i;; taken with a platinum loop and spread out on a carefully defatted slide. ThP preparation is air·dried and stained at room temperature in a dye solution, 0.2 to 0.3 gm. Sudan III in 100 c.c. of 70 per cent hot alcohol. The slide is washed in water, dried and examined immediately under low magnifying power. The fat substances are stained a distinct orange red; particles of mucus are sometimes stained weakl.v yellowish red. Of 141 samples taken before rupture of the membranes only 4 gave a slight positive Sudan reaction, the rest yielding a negative result (97.2 pt>r eent). Of the 139 samples taken after rupture only one gave a negative reaction. Slight Sudan reactions seem to be relatively more frequent in premature case~. The faulty reactions amount to about 2 per cent of the entire material.
,T. P.
GREENHILL.
Endres, P.: Does Premature or Early Rupture of the Membranes Influence the Length of Labor, Monatschr. f. Geburtsh. u. Gyniik. 105: 216, 1937.
Contrary to the general belief, Endres found that premature rupture of the membranes before the onset of labor shortened labor. This was true even when pregnancy was terminated prematurely or postmaturely. The shortening of labor takes place during the first stage. Renee the absence of the bag of waters not only does not influence the period of dilatation unfavorably, but it actually helps dilatation in many cases. The reason for this, in the opinion of the author, is the absence of resistance which is present when hydrostatic pressure is exerted by an intact bag of waters. On the other hand, rupture of the membranes after the onset of labor pains but before complete dilatation of the cervix, prolonged labor. In these cases the increase in labor is due to a prolonged first stage. The cause for this is a temporary atony of the uterus which follows rupture of the membranes. The practical significance of these findings is that premature rupture of the membranes is a justifiable procedure in certain cases. Above all, when premature rupture occurs spontaneously, drugs should not be given to hasten labor pains because they may have a detrimental effect. J. P. GREENHILL. Reiles: Induction of Labor in Cases of Premature Rupture of the Membranes, Bull. Soc. d 'obst. et de gynec. 25: 337, 1936. Reiles employs the Stein method of inducing labor. In a series of 7(1 cases labor was successfully induced in 64, i.e., in 84.2 per cent. In all the cases where labor was not induced the cervix was long anu uneffaced. The average duration of labor in the successful cases with spontaneous deliveries was eight hours anrl forty·eight Ininutes fur the printipara~ and four- hout~ lor the rnult.ipa~as. :i{o harm to the baby was observed.
J. P.
GREENHif,L.
Sunde, A.: Spontaneous and Artificial Rupture of the Membranes During Labor, Acta obst. et gynec. Scandinav. 17: 133, 1937. In 9,375 full-term labor cases observed at the Oslo Woman's Clinic, the time of rupture of the bag of waters was known. The author found that rupture of