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An internal pelvimeter for application during an abdominal cesarean section
AN
INTERNAL
LOUIS
PELVIMBTBR FOR APPLICATION ABDOMINAL GESAREAN SECTION”” RUDOLPH,
DURING
AN
M.S., M.D., F.A.C.S., CIHICAC;O, ILLI,. of Obstetrics, Cook County Hospital)
(Flon~ the Depwtment
A
ROUTINE prwedure in our clinic is the measurement of the obstetric conjugata vera of the pelvic inlet during the performanec of abdominal cesarean sections. The pelvimeters on the market have proved to be unsatisfad.ory for this purpose and stimulated the design of an instrument which has proved satisfactory.
Fig.
1.
The pelvimeter consists of a metal rod knobbed at one end and graduated in millimeters up to 20 cm. A movable metal indicator with a setscrew on its upper extremity is fitted to the metal rod. The indicator after being set to its indicated position is fixed by the se&crew [Fig. 1).
SANDWEISS ET AL.:
PERFORATION AND HEMORRHAGE OF PEPTIC ULCER
131
Our procedure is as follows: After the child is delivered, and before or after the hysterotomy incision is sutured, the obstetric conjugata vera is measured. The uterus is displaced laterally, the knobbed end of the metal rod is placed against the promontory of the sacrum and the lower end of the metal rod is placed aga,inst the superior border of the symphysis pubis. The indicator is moved to rest against the posterior surface of the symphysis pubis and is fixed by the setscrew. Then the instrument is removed and the measurement of the obstetric conjugata vera is determined when the operation is completed (Fig. 2). 55 EAST
WASHIKGTON STREET
DEATHS FROM PERFORATION AND HEMORRHAGE OF GASTRODUODENAL ULCER DURING PREGNANCY AND PUERPERIUM A Review of the Literature
and a Report of One Case
DAVID J. SANDWEISS, M.D., HAROLD M. PODOLSKY, M.B., HARRY C. SALTZSTEIN, M.D., AND AARON A. FARBMAN, M.D., DETROIT, MICH.
A
CTIVITY of peptic ulcer during pregnancy is rare. Ulcer complications, such as perforation or hemorrhage, are even more rare. Early recognition of these complications is import,ant so that adequate therapy may be promptly instituted. In previous communications,l, 2 we called attention to the rarity of active peptic ulcer and its complications during pregnancy, and the apparent beneficial influence of pregnancy on the symptoms and course of peptic ulcer. Reports in the literature show that a peptic ulcer may become active during pregnancy. Szenes3 while reporting instances indicating that pregnancy exercises a beneficial effect on the symptoms and course of peptic ulcer, presents brief case histories of seven pregnant women who experienced ulcer distress during their pregnancies. On one of them a gastroenterostomy was performed during the second month of gestation without ill effect. Mussey4 of the Mayo Clinic reported 370 operations of necessity during pregnancy over a period of ten years. Two of these were for peptic ulcer. Sandweiss, Saltzstein, and Farbmar? interviewed 46 women with proved duodenal ulcers. Twenty-five of these women had 52 pregnancies during the life history of their ulcers. One experienced ulcer symptoms during one of her pregnancies. Vignes” states that pregnancy may at times aggravate the symptoms of ulcer. Perforation and hemorrhage from gastroduodenal ulcer during pregnancy and the puerperium, and death resulting therefrom, are almost unheard of. Fellner’ states that not a single case of ulcer perforation was recorded in 38,000 births. Grace Abbott’ of the United States Department of Labor, Children’s Bureau., in a study on Maternal Mortality in fifteen states, reported that during the period from February, 1927, to July 1, 1929, there were l-176,603 l.ive births and 7,380 puerperal deaths. Of these deaths, four were due to intestinal obstruction and ten were due to some other diseasesof the digestive system. The
INTERNAL
LOUIS
PELVIMBTBR FOR APPLICATION ABDOMINAL GESAREAN SECTION”” RUDOLPH,
DURING
AN
M.S., M.D., F.A.C.S., CIHICAC;O, ILLI,. of Obstetrics, Cook County Hospital)
(Flon~ the Depwtment
A
ROUTINE prwedure in our clinic is the measurement of the obstetric conjugata vera of the pelvic inlet during the performanec of abdominal cesarean sections. The pelvimeters on the market have proved to be unsatisfad.ory for this purpose and stimulated the design of an instrument which has proved satisfactory.
Fig.
1.
The pelvimeter consists of a metal rod knobbed at one end and graduated in millimeters up to 20 cm. A movable metal indicator with a setscrew on its upper extremity is fitted to the metal rod. The indicator after being set to its indicated position is fixed by the se&crew [Fig. 1).
SANDWEISS ET AL.:
PERFORATION AND HEMORRHAGE OF PEPTIC ULCER
131
Our procedure is as follows: After the child is delivered, and before or after the hysterotomy incision is sutured, the obstetric conjugata vera is measured. The uterus is displaced laterally, the knobbed end of the metal rod is placed against the promontory of the sacrum and the lower end of the metal rod is placed aga,inst the superior border of the symphysis pubis. The indicator is moved to rest against the posterior surface of the symphysis pubis and is fixed by the setscrew. Then the instrument is removed and the measurement of the obstetric conjugata vera is determined when the operation is completed (Fig. 2). 55 EAST
WASHIKGTON STREET
DEATHS FROM PERFORATION AND HEMORRHAGE OF GASTRODUODENAL ULCER DURING PREGNANCY AND PUERPERIUM A Review of the Literature
and a Report of One Case
DAVID J. SANDWEISS, M.D., HAROLD M. PODOLSKY, M.B., HARRY C. SALTZSTEIN, M.D., AND AARON A. FARBMAN, M.D., DETROIT, MICH.
A
CTIVITY of peptic ulcer during pregnancy is rare. Ulcer complications, such as perforation or hemorrhage, are even more rare. Early recognition of these complications is import,ant so that adequate therapy may be promptly instituted. In previous communications,l, 2 we called attention to the rarity of active peptic ulcer and its complications during pregnancy, and the apparent beneficial influence of pregnancy on the symptoms and course of peptic ulcer. Reports in the literature show that a peptic ulcer may become active during pregnancy. Szenes3 while reporting instances indicating that pregnancy exercises a beneficial effect on the symptoms and course of peptic ulcer, presents brief case histories of seven pregnant women who experienced ulcer distress during their pregnancies. On one of them a gastroenterostomy was performed during the second month of gestation without ill effect. Mussey4 of the Mayo Clinic reported 370 operations of necessity during pregnancy over a period of ten years. Two of these were for peptic ulcer. Sandweiss, Saltzstein, and Farbmar? interviewed 46 women with proved duodenal ulcers. Twenty-five of these women had 52 pregnancies during the life history of their ulcers. One experienced ulcer symptoms during one of her pregnancies. Vignes” states that pregnancy may at times aggravate the symptoms of ulcer. Perforation and hemorrhage from gastroduodenal ulcer during pregnancy and the puerperium, and death resulting therefrom, are almost unheard of. Fellner’ states that not a single case of ulcer perforation was recorded in 38,000 births. Grace Abbott’ of the United States Department of Labor, Children’s Bureau., in a study on Maternal Mortality in fifteen states, reported that during the period from February, 1927, to July 1, 1929, there were l-176,603 l.ive births and 7,380 puerperal deaths. Of these deaths, four were due to intestinal obstruction and ten were due to some other diseasesof the digestive system. The