Intrauterine rupture of a velamentous umbilical cord

Intrauterine rupture of a velamentous umbilical cord

664 THE AXERICAN and we cannot the cervix, and DR. expect a result then labor will KEDARXilTH postmature JOURXAL cases, how OF OBSTETRICS ...

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664

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DR. WATSON (resuming).-1 have not the exact figures at my command, but a very considerable number of these were primiparous patients who had gone beyond term. In reply to Dr. Spalding, the solution of quinin I use is quinin hydrochlorid, dissolved with 10 minims of hy&ochloric acid to 10 grains of quinin. Patients object to the taste, but they are willing to put up with that with the prospect of a fairly rapid termination of their pregnancies. In answer to Dr. Darnall, we use the bags and catheter or bougies occasionally, but we have occasional failures. If a bag is used the patient has pain, and when the bag is taken out the pain ~ascs. One-half c.c. of pituitrin administered at that stage will effectively start labor, and I think the use of pituitrin in such cases is a rery good thing. DR. RUCKER (closing on his part j .-With regard to the question of Dr. Morse, in the first stage observations you can definitely identify the contractions. The uterine contractions are long ware-like contractions, while the contractions of the abdominal muscles are of the short up ancl down type. They are mere lines on the record. In the postpartum or third stage observations, where‘ you get marked coatraction of the uterus, there is a noticeable depression which is maintained for a minute or more. The same thing is done with the abdominal muscles, but for shorter intervals. The respiratory action of the abdominal muscles may mask a slight con.traction of the uterus. The thing that started us off was that ergot gave such slight results as compared with the action of pituit.rin. We t,ried to measure the difference in the effect of ergot and pituitrin. If you use large enough doses, say three times as much ergot as the ordinary dose, you get a pituitrin-like effect. Dr. Joseph Tabor Johnson in a paper on ergot presented before the Society in 1852, made the statement that mankind would be a great deal better off if ergot was abandoned. If that statement is true of agot, what shall we say of pituitrin, which is a much more powerful drug?

Kew York, presented a paper on Intrauterine of a Velamentous Umbilical Cord. (For original article see page 619.)

DR. GEORGE W. KOSMAK,

Rupture

DISCUSSION DR. M. PIERCE RUCKER, RICHMOND, VIRGISIA.-ShOFtly after getting a copy of the program I had a case which may be of some interest to relate. It was a normal delivery. The cord was clamped; the patient started to bleed. I pressed on the abdomen, and about three or four inches from the vulva the umbilical vein rupture and spurted blood all over the nurse. This case shows the ease with which these things may happen. There was no undue pressure made on the fundus.

DR. ALFRED

C. BECK, Brooklyn, N. Y., by invitation,

presented a paper

on Is Interference JusWlable aXter Twenty-four Hours of Labor When No Other Indication Is Resent? (For original article see page 623.)