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Obstetric problems arising from excessive size of the infant
545
ABSTRACTS ligamentous, and involution
extirpation of the
may genital
be referred until organs has taken
the patient place.
has completely
recovered
J. P. GREENHILL. Zoller, C. Geburtsh.
M.: Labor and Puerperium u. Gyniik. 113: 25, 1942.
in
Overweight
Women,
Monatshr.
f.
The author investigated a series of 600 pregnant women who were overweight. He found that such women have a tendency to develop kidney trouble, pre-eclampsia, and eclampsia. A large proportion have premature rupture of the membranes. Because of the difficulties in labor, operative interference is more necessary than usual. Likewise, hemorrhages in the third stage are common. The puerperium is frequently febrile. The author warns that more careful observation of fat women is neressary. The diet of these women should be earefully controlled. J. P. GKEENHILL. Wilson, New
Karl York
M.: Obstetric Problems J. Med. 42: 883, 1942.
Arising
From
Excessive
Size
of the
Infant,
A series of 495 infants whose birth weight was 1,000 Gm. or over is presented. There were 82.3 per cent of the labors terminated spontaneously, operative interWhen ference was necessary in 17.7 per cent, while labor was induced in 5.6 per cent. dystocia occurs in connection with the baby of excessive size, the difficulty is seldom due to excessive size of the head but rather is the result of shoulder dystocia. The risk to the baby increases greatly when the weight exceeds 4,500 Gm. Thus, in this series, the fetal mortality in infants weighing 4,000 to 4,499 Gm. was 3.2 per cent, in those weighing 4,500 to 4,999 Gm. it was 4.8 per cent, while the mortality figure reached 36.0 per cent in infants weighing 5,000 to 5,499 Gm. and was 100 per cent in three infants weighing over 5,500 Gm. Birth injuries were rather more frequent than usual in the series, such injuries including six cases of Erb’s palsy and three fractured clavicles. Suggestions for management of this situation include dietary restriction of fat-forming foods taken by the mother during the last weeks of pregnancy, induction of labor when a child of unusual size is discovered in the latter part of pregnancy, and cesarean section in properly selected cases, espec>ially if the child appears to be over 5,500 Gm. Makepeace,
A. W.:
The
Home
Delivery
Service,
The
Child
7: 36, 1942.
Makepeace, now Consultant in Obstetrics, North Carolina State Board of Health and Professor of Obstetrics, School of Public Health, North Carolina, was engaged, by the Children’s Bureau, to survey and study the home-delivery services in 15 medical schools for white students. Most of the schools, listed by alphabetical legend, were in the southern part of the United State?. In all 15 schools visited, the students, prior to assignment to the home-delivery service, received instruction in basic normal obstetrics but in only 10 of the 15 schoolr was the home investigated to determine its suitability for delivery. Transportation to the home was a student problem in all but 1 of the 15 institutions. Student responsibility, during labor and delivery, varied from zero (3 schools) to 100 per cent (2 schools). The caliber of medical care varied from mediocre to adequate. (Detailed charts demonstrate these facts excellently.) The nursing care in the home-delivery service was found to be variable. A nurse was required to be present in only 7 of thr 15 schools conducting home-delivery service. Morbidity and mortality records were available in only 8 of t.he 15 inntitutions visited.
ABSTRACTS ligamentous, and involution
extirpation of the
may genital
be referred until organs has taken
the patient place.
has completely
recovered
J. P. GREENHILL. Zoller, C. Geburtsh.
M.: Labor and Puerperium u. Gyniik. 113: 25, 1942.
in
Overweight
Women,
Monatshr.
f.
The author investigated a series of 600 pregnant women who were overweight. He found that such women have a tendency to develop kidney trouble, pre-eclampsia, and eclampsia. A large proportion have premature rupture of the membranes. Because of the difficulties in labor, operative interference is more necessary than usual. Likewise, hemorrhages in the third stage are common. The puerperium is frequently febrile. The author warns that more careful observation of fat women is neressary. The diet of these women should be earefully controlled. J. P. GKEENHILL. Wilson, New
Karl York
M.: Obstetric Problems J. Med. 42: 883, 1942.
Arising
From
Excessive
Size
of the
Infant,
A series of 495 infants whose birth weight was 1,000 Gm. or over is presented. There were 82.3 per cent of the labors terminated spontaneously, operative interWhen ference was necessary in 17.7 per cent, while labor was induced in 5.6 per cent. dystocia occurs in connection with the baby of excessive size, the difficulty is seldom due to excessive size of the head but rather is the result of shoulder dystocia. The risk to the baby increases greatly when the weight exceeds 4,500 Gm. Thus, in this series, the fetal mortality in infants weighing 4,000 to 4,499 Gm. was 3.2 per cent, in those weighing 4,500 to 4,999 Gm. it was 4.8 per cent, while the mortality figure reached 36.0 per cent in infants weighing 5,000 to 5,499 Gm. and was 100 per cent in three infants weighing over 5,500 Gm. Birth injuries were rather more frequent than usual in the series, such injuries including six cases of Erb’s palsy and three fractured clavicles. Suggestions for management of this situation include dietary restriction of fat-forming foods taken by the mother during the last weeks of pregnancy, induction of labor when a child of unusual size is discovered in the latter part of pregnancy, and cesarean section in properly selected cases, espec>ially if the child appears to be over 5,500 Gm. Makepeace,
A. W.:
The
Home
Delivery
Service,
The
Child
7: 36, 1942.
Makepeace, now Consultant in Obstetrics, North Carolina State Board of Health and Professor of Obstetrics, School of Public Health, North Carolina, was engaged, by the Children’s Bureau, to survey and study the home-delivery services in 15 medical schools for white students. Most of the schools, listed by alphabetical legend, were in the southern part of the United State?. In all 15 schools visited, the students, prior to assignment to the home-delivery service, received instruction in basic normal obstetrics but in only 10 of the 15 schoolr was the home investigated to determine its suitability for delivery. Transportation to the home was a student problem in all but 1 of the 15 institutions. Student responsibility, during labor and delivery, varied from zero (3 schools) to 100 per cent (2 schools). The caliber of medical care varied from mediocre to adequate. (Detailed charts demonstrate these facts excellently.) The nursing care in the home-delivery service was found to be variable. A nurse was required to be present in only 7 of thr 15 schools conducting home-delivery service. Morbidity and mortality records were available in only 8 of t.he 15 inntitutions visited.