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Air embolism in criminal abortion
112
AMERICAN .JOURNAL OF OBSTETRICS ANI) GYNECOLOGY
an argument again11t the ust> of large doses of the sulfonamide!! for prophylactic purposes. At the Lausanne Maternit,v the author ha~ u11ed ''sulfa'' therapy prophylartically and therapeutically in ea""" of abortion. In the febrile eases there was a diminution in the number of day~ of fever aR eomparetl with patients who did not receive sulfa drugs. Howt>wr, no differenet> was observed in the eon, trol and Rulfa group who had no compliration~. The prophyladif· use of sulfa drug" not only did not prevent a fatality hut in ~t•mt> ra>nde,J to pr(l{lm'e u persistt>nct> of mild fever for a long timl'. Tht>r<>fort' th<> authm· ~ays that tlw pl'PVPntivP U;;l(' of sulfa drug~< in r!l~eH of abortion i~ at prtll'i>nt without any ,·aJtw . .J. P.
Weilerstein, Ralph W.: Intrauterine Pastes, .J. A. 1\f. A. 125:
~0;),
GRFJp;NHIJ.L.
Hl-14.
The author reports his finding;; r~vit>wing som~ abortion faJalities anJ inq\liflefl in connection with tht> use of soap pastes. The toxic effect!< art> listed in two groups, systemic and local. The 11ystemi<:> effec·t~<, such a~< hemolysi~, jaundiee, pulmonary embolism, and septicemia, are the most marked. Sterility (tubal occlusion) and hem· orrhage are the two most common local reactions. Peritonitis is not an uncommon finding. The author states that he ha~ been informed by physicians who have used thiA paste that it i!< ineffective in 5.0 per !'!'nt of the cases. Appropriate strs nf thP~e produl'ts under thP Federal Food, Drug, and Cosmetie Aet. W!UJA~f BERMAN.
Teare, Donald:
Air Embolism in Criminal Abortion, Lan(·et 247: 242, 1944.
Teare reports a fatality indueed by air embolism following an attempt to induce an abortion of a purported three months' pregnancy. A soap and water mixture were introduced into the vagina by means of the enema syringe. Tl1e 18·year·old unmarried girl became immediately cyanotic and collapsed. \Vhen the police ar· rived :fifteen minutes later, the patiry were found to be pink and filled with bubble~. No bubbles were detected on the systemic side of the cireulation. The bubbles were iridescent. The author states that the volume of liqui{l expelled at one squeeze of an ordinary t>nema syringe is approximately 43 c.<>. and into an enclosed space it is delivered at a pressure which easily reaches 28 em. of mercury or 380 em. of water. When the ball-val~e end of a syringe was dipped in.tn the frothy soapy water, it was found that about 2:3 c.<'. of air passed through the syringe for every i
Gynecologic Operations Flax, H. J.: The Use of Cotton Sutures in Lower Abdominal Surgery, Bol. Asoc. rued. de Puerto Rico 36: 170, 1944. Continuous cotton thread sutures were used sueeessfully by H. J. Flax in the peritoneal and fascial closure of lower abdominal wounds, thus speeding up the tirne of operative technique to equal that of catgut. Single unit, number 50, cotton thread is recommended; where t>tronger suture is needed, this thread is doubled or tripled. One case of incisional hernia in a right rectus incision. is reporf.ed. Thiswa.s due to faulty technique with poGr approximation of the lower end· of the anterior rectus layer, rather than to the use of a. continuous cotton suture. The advantages of cotton thread are: low cost, easy availability; remains stable on expo.sure to heat and moisture and is easily sterilized; a high eoetlieient of friction allowing the tying of seeure knots; !utd1 that it doee< not irritate the wound,
AMERICAN .JOURNAL OF OBSTETRICS ANI) GYNECOLOGY
an argument again11t the ust> of large doses of the sulfonamide!! for prophylactic purposes. At the Lausanne Maternit,v the author ha~ u11ed ''sulfa'' therapy prophylartically and therapeutically in ea""" of abortion. In the febrile eases there was a diminution in the number of day~ of fever aR eomparetl with patients who did not receive sulfa drugs. Howt>wr, no differenet> was observed in the eon, trol and Rulfa group who had no compliration~. The prophyladif· use of sulfa drug" not only did not prevent a fatality hut in ~t•mt> ra>
Weilerstein, Ralph W.: Intrauterine Pastes, .J. A. 1\f. A. 125:
~0;),
GRFJp;NHIJ.L.
Hl-14.
The author reports his finding;; r~vit>wing som~ abortion faJalities anJ inq\liflefl in connection with tht> use of soap pastes. The toxic effect!< art> listed in two groups, systemic and local. The 11ystemi<:> effec·t~<, such a~< hemolysi~, jaundiee, pulmonary embolism, and septicemia, are the most marked. Sterility (tubal occlusion) and hem· orrhage are the two most common local reactions. Peritonitis is not an uncommon finding. The author states that he ha~ been informed by physicians who have used thiA paste that it i!< ineffective in 5.0 per !'!'nt of the cases. Appropriate strs nf thP~e produl'ts under thP Federal Food, Drug, and Cosmetie Aet. W!UJA~f BERMAN.
Teare, Donald:
Air Embolism in Criminal Abortion, Lan(·et 247: 242, 1944.
Teare reports a fatality indueed by air embolism following an attempt to induce an abortion of a purported three months' pregnancy. A soap and water mixture were introduced into the vagina by means of the enema syringe. Tl1e 18·year·old unmarried girl became immediately cyanotic and collapsed. \Vhen the police ar· rived :fifteen minutes later, the patiry were found to be pink and filled with bubble~. No bubbles were detected on the systemic side of the cireulation. The bubbles were iridescent. The author states that the volume of liqui{l expelled at one squeeze of an ordinary t>nema syringe is approximately 43 c.<>. and into an enclosed space it is delivered at a pressure which easily reaches 28 em. of mercury or 380 em. of water. When the ball-val~e end of a syringe was dipped in.tn the frothy soapy water, it was found that about 2:3 c.<'. of air passed through the syringe for every i
Gynecologic Operations Flax, H. J.: The Use of Cotton Sutures in Lower Abdominal Surgery, Bol. Asoc. rued. de Puerto Rico 36: 170, 1944. Continuous cotton thread sutures were used sueeessfully by H. J. Flax in the peritoneal and fascial closure of lower abdominal wounds, thus speeding up the tirne of operative technique to equal that of catgut. Single unit, number 50, cotton thread is recommended; where t>tronger suture is needed, this thread is doubled or tripled. One case of incisional hernia in a right rectus incision. is reporf.ed. Thiswa.s due to faulty technique with poGr approximation of the lower end· of the anterior rectus layer, rather than to the use of a. continuous cotton suture. The advantages of cotton thread are: low cost, easy availability; remains stable on expo.sure to heat and moisture and is easily sterilized; a high eoetlieient of friction allowing the tying of seeure knots; !utd1 that it doee< not irritate the wound,