Chloral hydrate in labor

898

AMERICAN ,JOt:RNAL Of<' OBS'rETRICS AND GYNECOU)GY

mal women. 2. Prophylaetic forcep:< at thP end of the HE>eond stage, although not necessary in most case8, should be used wht>u labor is lung, when the nt<>rine cavity was opened to remove the fibroma, or wlwn a number of fihroids werf' extirpated. ::. The puerperium pr·ogres~ed unewntfully. 4. '!'he operation doe,; not interfere with fetal development. 5. Reeurrence of myoma,; i>< extremp]_v ran· and does not in· validate the con~ervative tretttment. ll. The experieuo·e nl· the ohstetrk fut uri' myomect.omized women is O!IC' more argument on bPhalf of' •·oruervativt> ~urger;• of the uterus. .r. P. GR~;~;NmLr. Bravo, Rogelio Rodriguez: Experience With Zarate's Partial Subcutaneous Symphysiotomy, An. Inst. de Mat. y Asist. Soc. 2: 14J, 1\140. Rogelio Rodriguez Bravo review!' 63 cases observed betweE'n Hl2H and Hl::l9, an correctly used according to Zarate'~ technique when it i~ possible to rel,\· on good dynamics and amplitude of the soft parts to obtain spontaneouR parturition; in many •:a~e~ it gives the patient a dilatation that permanently solves O!ia . .T. P. GREENHILL Beruti, Josue A.: Chloral Hydrate in Labor, Arch. Clin. ohst. y ginec. Eliseo Canton 1: 58, 1942. Josue A. Beruti state~ that his experience of 10 years with thi8 drug shows that it fails in many cases; however, the failures must be largely attributed to incorrect indication and insufficient dosage. In correct dosage and provided that the enemas do not contain more than 3 Gm. of thP drug and arc not repeated too frequently, it has no disturbing effects on the evolution of labor, preHPnts no risks for mother or fetus and has no unfavorable action on placental delivery or post-partum. Often the association of chloral hydrate and ~pasmalgin has an excellent effect on dilatation of the cervix. ,J. P. GREENHJI,f,

Sala, Silvestre Luis: Value of Rectal Examination in Obstetrics, Arch. Clin. obst. y ginec. Eliseo Canton 1: 118, J!l42. From an exten~ve review of the literature and a statistic of 2,000 observations, Silvestre Luis Sala concludes that rectal examination during labor decreases puer· peral morbidity, but gives les;;; exact diagnostic information than vaginal examina· tion. This is due to the frequently unavoidable uiffic•.ulties peculiar to the method and depending on the height of the pre~entation. However, the> index of inacc>uracy in the diagno;;is of the uilatation and the height of the ptesentation are not consider" able, while vaginal examination made under aHeptie conditions is not as dangerous as has been claimed. Therefore, the author recommends that rectal examination be used only to verify the progress of labor and that vaginal exarnination be made in the beginnipg and be resorted to in ease of the sligMest douht, or if a more accurate diagnosis becomes necessary. .r. P. GREE!'<'HII,L