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Death from hyperemesis gravidarum
Department CONDUCTED
of Reviews and Abstracts BY HUGO
EHRENFEST,
M.D.,
ASSOCIATE
EDITOR
Selected Abstracts Pathology
of Pregnancy
Cabanes, P. A.: A Simple Treatment of Hyperemesis Sot. d’obst. et de gynk 6: 420, 1930.
Gravidarum.
Bull.
de la
Eleven cases of hyperemesis gravidarum are reported by Cabanes in which cures were obtained by either the production of fixation abscesses or the injection of aseptic pus. In all the cases the vomiting subsided rapidly after the injections and the pregnancy continued unmolested in all cases but one where typhoid fever was present. The author, however, does attach great importance to the diet which is as follows: restriction of fluids, frequently repeated small meals composed of purees of vegetables and fruit, and glucose injections to prevent dehydration. J. P.
Aburel, E. : Considerations of the Pathogenesis and Treatment Pregnancy. Bull. de la Sot. d’obst. et de gyn&. 7: 34, 1931.
GREENHILL.
of Vomiting
in
The author’s conception of the mechanism of vomiting during pregnancy is as follows : In a nervous, spasmophilic and susceptible individual, the irritation of the uterus during pregnancy produces an uterogastric reflex. The uterus incites a spasm of the pyloric portion of the stomach and vomiting results. The author says he verified his idea of the pathogenesis of vomiting in pregnancy by therapeutic results which he obtained by anesthetizing the eentripetal path of the uterus. By anesthetizing the lumboaortic plexus one may give a woman who has not been able to keep any food in her stomach, a large meal which will be well tolerated. Two cases are reported in which complete cures were obtained after two anesthesias. J. P. GREENHILL.
Saenger, H. :
Death From Hyperemesis
Gravidarum.
Arch,
f. Gynlk.
142:
152,
1930. The author reviews at length the history of hyperemesis gravidarum and gives a r&mm8 of all the 33 cases in the literature, which ended fatally. He also adds one case of his own. An analysis of the reported cases leads Saenger to conclude that pregnancy should be terminated promptly for continuous and uninterrupted vomiting, especially when lasting more than one week with a pulse above 96, marked loss of weight and weakness. The interruption should be done, if at all, before the ninth week of pregnancy as all the reported deaths occurred after the ninth week. The development of neuritides, pyrexia, or ieterus are forebodings of serious pathologic changes and clearly indicate prompt interruption of the pregnancy. The negative chemieophysieal findings are of no value in the prognosis. The development of fever, or of cerebral changes such as apathy, delirium, etc., are evidences that the proper moment for interruption has already passed. RALPH
457
A.
REIS.
of Reviews and Abstracts BY HUGO
EHRENFEST,
M.D.,
ASSOCIATE
EDITOR
Selected Abstracts Pathology
of Pregnancy
Cabanes, P. A.: A Simple Treatment of Hyperemesis Sot. d’obst. et de gynk 6: 420, 1930.
Gravidarum.
Bull.
de la
Eleven cases of hyperemesis gravidarum are reported by Cabanes in which cures were obtained by either the production of fixation abscesses or the injection of aseptic pus. In all the cases the vomiting subsided rapidly after the injections and the pregnancy continued unmolested in all cases but one where typhoid fever was present. The author, however, does attach great importance to the diet which is as follows: restriction of fluids, frequently repeated small meals composed of purees of vegetables and fruit, and glucose injections to prevent dehydration. J. P.
Aburel, E. : Considerations of the Pathogenesis and Treatment Pregnancy. Bull. de la Sot. d’obst. et de gyn&. 7: 34, 1931.
GREENHILL.
of Vomiting
in
The author’s conception of the mechanism of vomiting during pregnancy is as follows : In a nervous, spasmophilic and susceptible individual, the irritation of the uterus during pregnancy produces an uterogastric reflex. The uterus incites a spasm of the pyloric portion of the stomach and vomiting results. The author says he verified his idea of the pathogenesis of vomiting in pregnancy by therapeutic results which he obtained by anesthetizing the eentripetal path of the uterus. By anesthetizing the lumboaortic plexus one may give a woman who has not been able to keep any food in her stomach, a large meal which will be well tolerated. Two cases are reported in which complete cures were obtained after two anesthesias. J. P. GREENHILL.
Saenger, H. :
Death From Hyperemesis
Gravidarum.
Arch,
f. Gynlk.
142:
152,
1930. The author reviews at length the history of hyperemesis gravidarum and gives a r&mm8 of all the 33 cases in the literature, which ended fatally. He also adds one case of his own. An analysis of the reported cases leads Saenger to conclude that pregnancy should be terminated promptly for continuous and uninterrupted vomiting, especially when lasting more than one week with a pulse above 96, marked loss of weight and weakness. The interruption should be done, if at all, before the ninth week of pregnancy as all the reported deaths occurred after the ninth week. The development of neuritides, pyrexia, or ieterus are forebodings of serious pathologic changes and clearly indicate prompt interruption of the pregnancy. The negative chemieophysieal findings are of no value in the prognosis. The development of fever, or of cerebral changes such as apathy, delirium, etc., are evidences that the proper moment for interruption has already passed. RALPH
457
A.
REIS.