- Email: [email protected]
Comparison of Fetal Mortality Rates
Comparison of Fetal Mortality Rates Tn the Eililor8: I read with interest the artide prepare<] i>~· Dr~. Erving' an~I> GvN~~coLO(i\·, vol. t\7, p. :.115, FPhruary, 1!1,)4 ·· Although, I wonlrl ftnd it diflkult to follow their example, they J,a,·e eertrtinly rl'' iew.,rl " worth-while group of ~ase~. How<>YN, I mu~t elnrify e<'rt ai n remarks m:vl(•, pan i<·uiarly in reference to the article on midforcepR (AMEIUCAN .lonn:AL PF OHSTE'I'Rir·,: .\:\11 (;v::-n-: COLOGY, vol. 6;'5, p. 294, February, 195:1) hy lJl:'F. Dickson, Heaton, and my:<<'lL They h::wc eornpared a fetal mortalitr of 2.7 p...r eNll in their serie:< with 1.7.> [' 1' 1' eent in our midforcepR eases, yet it iR ohYiouR that they have ,•orrN·te<1 t.lwir figun·~ with different factor~ tl1an we used. Our figure of +. i£; pt>r ~t>nl wa> (·orrt>d<'d 1>~, the .,!imina tion of maei'rnted ~tillhorn infants, babie~ with eongenital anomaliPf' int'ompatihl .. with life, and habie~ under:: pound~ that died. {'l'hPn' wert' IIOllP of thi~ latte' ~roup i>J <.·l In thl'ir pati.entR they e1iminate~•· :iu"-1 memif)!Wahit'~ tramn:t •·.,uld ni>L 1. .. definitely excluded as a eause of fetal deatl1. This wonl1! gin• uR a fetal mortality «f per ~<'nt due to this factor. 'I'his figur;> is tlw otlP that ,;}wul,l bt• <'Ont[HH1!<1 t<· tl•••ir ::.1 per rrnt mortality as it is more nenrly eorrel'l<·rl for Ill<' :;mne fartors thPy hav.• us<' f<'tal mortality as a r~>sult of trauma was 0.6 pe.r <•PnL whir·h lt•d u~ tn <'On<'lmlt· WI' "'''''" using midforct'pl'l less often in unsuitable eases. Drs. E1·ving and Kenwick have also otTerc•d ItS rebuttal to our remark · · >Yiwll i'r•r•'e]'" fail there is little reason to helieve that a 1ive. uninjurerl hahy ran he olJtainPd 1,y 'ersion and extraction.'' forty·nine infants delivered h,\' thiR method following- failed fol'('"l"· T·• me this repreRents an uncommonly large numhPr of faile in this group those eaRf\S in which we: were nn,thlP tH apply the fon•ep~ prorwrh, Thif' lattrr group is ,.Jassified aR ''attempted forr.eps. · · ?\KW YoRK t'NlVERSITY COLLEGE OF MEJJli'll\:1>:
-177 FIRST AVF.NlTF; Xnv YoRK Hi, X. Y. MARCH ~~. 1954
Reply of Drs. Erving and Kenwick Tn the Editors: We weleome the opportunity to diseus:-. the points hrought. out by Dr. Wayne Deckerin hiH letter regarding our recent paper on internal podalie verHiOn and I'XIra<'tion ( A~L ,T, OnsT. & Gv="!EC. 67: 3151 1954) in which W<' cited hi;< paper on midforcep~ ( A·:.r ..T. OBST. & GYNEC. 65: 2941 1953) . .As stated in our article the corrected fetal moJ'tality excluded :32 of the 6;.) babiel' lost. Dr. Deeker apparently takes exception to our inclmHng nine cases of these i)2, claiming that we have corrected our figures with different factors than he used. Table XI in our paper lists the specific cause of death as determined by postmortem examination. Even if a baby was macerated but a specific cause of death was determined,, it wa~ listl:'d under the actual cause. Therefore, the ''macerated viable stillborn'' categor~· of Dr. Decker would include the :five cases of prolapse of the cord in which the fetal heart sound" were not heard prim· to delivery, the case of premature separation and prolapse of the
-177 FIRST AVF.NlTF; Xnv YoRK Hi, X. Y. MARCH ~~. 1954
Reply of Drs. Erving and Kenwick Tn the Editors: We weleome the opportunity to diseus:-. the points hrought. out by Dr. Wayne Deckerin hiH letter regarding our recent paper on internal podalie verHiOn and I'XIra<'tion ( A~L ,T, OnsT. & Gv="!EC. 67: 3151 1954) in which W<' cited hi;< paper on midforcep~ ( A·:.r ..T. OBST. & GYNEC. 65: 2941 1953) . .As stated in our article the corrected fetal moJ'tality excluded :32 of the 6;.) babiel' lost. Dr. Deeker apparently takes exception to our inclmHng nine cases of these i)2, claiming that we have corrected our figures with different factors than he used. Table XI in our paper lists the specific cause of death as determined by postmortem examination. Even if a baby was macerated but a specific cause of death was determined,, it wa~ listl:'d under the actual cause. Therefore, the ''macerated viable stillborn'' categor~· of Dr. Decker would include the :five cases of prolapse of the cord in which the fetal heart sound" were not heard prim· to delivery, the case of premature separation and prolapse of the