Electronic monitoring of labor

568

October Am. J. Obstet.

Correspondence

Fig. 3. The use of the angulated repair of a cystocele.

Fig. 1. Photograph of the Allis

showing

size

and

angulation

Electronic

Allis

Clamps

Ciamps

in

This instrument is especially useful in vaginal surgery. Fig. 2 shows how the clamps can be used in rectocele repair work, and Fig. 3 shows how the clamp can be used in cystocele repair work; excellent vision can be had with the use of these clamps. The clamp can be used in other types of surgery, especially in small, deep cavities. These clamps are manufactured by the Lawton Instrument Company. W. C. CuubEe, M.D., F.A.C.S. Surgical Service St. Joseph Hospital 1148 S. hillside Wichitu, Kansas 67211

Clamps,

Fig. 2. The use of the angulated repair of a rectocele.

Allis

15, 1974 Gynecd.

in

monitoring

of tuber

To the Editors: I read with interest the paper by Edward H. Hon, M.D., entitled “Additional observations on ‘pathologic’ bradycardia” (AM. J. OBSTET. GYNECOL. 118: 428, 1974). I would like to point out that he has incorrectly quoted our paper entitled, “Labor monitoring, a practical experience” (Obstet. Gynecol. 36: 875, 1970). We never stated that electronic monitoring of labor does not add any information to that obtainable with a stethoscope. We said in our conclusion, page 879, that labor monitoring is praetical, but has limitations, and on the same page, we stated in Iines 6 to 19, right column: “The supervision of labor, when viewed with respect to IUP and FHR recording, provides the physician with a permanent record of the progress

Volume

Correspondence

120

Number4

and safety of labor at any stage. This may be especially useful when oxytocin is administered in crowded delivery rooms, when the obstetrician must rely upon periodic observations by many different observers, and when a high-risk patient is in labor. Although representative patterns of normal labor may be difficult to predict, the data are valuable to detect the presence of abnormal or tetanic contractions.” lacques F. ROUX, M.D. PTO~~SSOTof Obstetrics and ~y~e~olog~ Cuyahoga County tiospital 3395 Scranton Rd.

Reply

to Dr. Roux

To the Editors: I apologize for the misinterpretation of a statement from the “Conclusions” of the report of Roux and associates (Obstet. GynecoI. 36: 875, 1970). For reference, the statement in question is quoted : “The main contribution in monitoring methods is that it offers better medical and paramedical care to the patient by obliging doctors and nurses to watch labor around the clock.” I interpreted this conclusion to mean that the monitor had no value per se, it was merely a way to oblige doctors and nurses to watch patients. If this is what the authors meant, I conciuded that fetal monitors per se did not add anything to auscultatory techniques for fetal evaluation. Edward H. Won, M.D. Dare Professor of Obstetrics and Gynecology Chief, Section of Perinatal Biology Women’s ~o~~~tul 1240 N. Mission Rd. Los Angeles, California 90033

Removal Dalkon

of intraperitoneal Shields

To the Editors: We read with interest the paper by Merrill, Burd, and VerBurg entitled “Laparoscopic removal of intraperitoneal Dalkon Shields: A report of three cases” (Am. J. OBSTET. GYNECOL, 118: 1146, 1974). In this paper the authors recommend the use of the second-puncture technique with a fiberglass cannula and removal of the Dalkon Shield with the Eder-Cohen forceps. We have successfully removed a perforated

569

Dalkon Shield from the cul-de-sac with the single-puncture technique. The standard laparoscope and grasping forceps were used and simultaneously removed with no difficulty. We wonder if this method might be more advantageous than the two-puncture technique since the possibility of vascular injury with a second puncture is always a consideration in this procedure. We, too, recommend the immediate removal of intrauterine contraceptive devices when the diagnosis of perforation is made and completely agree with the authors, Incidentally, we have stopped using Dalkon Shields entirely because of the high pregnancy rate and high incidence of uterine perforation suggested by recent clinical reports. James S. Powers, M.D., Major, MC, USA Jay M. Hill, M.D., Colonel, MC, USA Department of Obstetrics-Gynecology Department of the Army Fitrsimons Army Medical Center Denver, Colorado 80240

The oncogenic potential of dye-light treatment of herpetic lesions To the Editors: Recent experimental data indicate that photodynamic inactivation of herpes simplex virus with heterocyclic dyes1 is a proved effective regimen for arresting herpes simplex virus infections of the skin and mucous membranes and decreases the rate of recurrent infections in human subjects. a-4 Other experimental evidence shows that a combination of the photodynamic dye neutral red and fluorescent light is significantly more effective than the conventional idoxuridine therapy in treating herpes simplex virus type I (NSV-1) cornea1 infections in rabbits.5 Photodynamic inactivation of herpes viruses occurs when a heterocyclic dye such as neutral red combines with critical sites in the virus deoxyribonucleic acid (DNA) to form a dyeDNA complex. When the complex is exposed to visible light, it adsorbs a photon of light energy and attains a metastable excited state. The excited complex then combines with oxygen in a reaction which causes an excision of the viral DNA molecule and blocks virus multiplication. Although the causative role of herpes simplex virus type 2 (HSV-2) in cervical carcinoma has not been established, a definite association is present.“-9 Frenkel and co-worker@” showed that