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Prognosis in Premature Rupture of the Membranes
ABSTRACTS
611
Labor, Physiology, Management, Complications Ahumada, J. L., and Diradourian, J.: The Dangers of Infection Through Manual Removal of the Placenta, Arch. Clin. ob.st. y ginec. '' Eliseo Canton" 1: 792, 1942. The authors analyze 702 cases of manual removal of the placenta, from the Eliseo Canton. The ine.idence of manual removal at this institution was 1.33 per cent. The total mortality was 8.1 per cent, of which deaths from sepsis occurred in 3.3 per cent. The more infected the cases were at the time of manual removal, the graver was the prognosis. The authors therefore emphasize that, while thiB manipulation is relatively harmless in nonfebrile cases, it is serious in women who are infected. In view of this, the danger of manual removal of the placenta as an operative procedure has been greatly exaggerated. Because of this, a placenta should be removed early in the presence of serious ilemorrhage. J.P. GREENHII,L. Cootz, A. S.: Prognosis in Premature Rupture of the Membranes, Arch. Clin. obst. y ginec. "Eliseo Cant6n" 1: 818, 1942. Author maintains that premature rupture of the me~branes has an unfavorable prognosis because it results in interruption of gestation prematurely and it may lead to amniotic infection. Furthermore, the following disturbances may follow premature rupture: anomalies in uterine contraction, increase in eomplications of the third stage of labor, greater frequency of operative interference and unfavorable effect on the fetus. There is also an increase in morbidity and mortality during the puerperium. J.P. GREENHILL. Beruti, J. A.: Antispasmodic Treatment During Spontaneous Labor and Its Effect on the Fetus, Arch. Clin. obst. y ginee. "Eliseo Canton" 1: 699, 1942. Beruti administered spasmalgine and chloral hydrate to groups of women in labor and studied the effects of these drugs on the babies. In the cases of spontaneous labor, spasmalgine had no bad effects on the babies. In. a second group chloral hydrate was given to women who were having prolonged and difficult labor and again the babies fared well. The author compared the effects of spasmalgine and chloral hydrate and concluded that chloral hydrate is probably less harmful to the newborn than spasmalgine. J. P. GREENIULL. Biggins, L. G., F.R.C.S.: 1943.
Cesa,rean Section in Dystocia, Brit. M. J. 4285: 212,
Higgins suggests ''that the operation of Cesarean section involves less risk than difficult vaginal delivery, and that the indications for abdominal delivery may be considerably exttlnded with advantage to mother and child.'' He reports two series of personal eases, making 220 in all, which have been operated since 1931. One is a series of 157 elective operations; the other comprises 63 operations performed late in labor. He gives some statistics describing his operative technique, compares results with series of forceps deliveries, and closes with the following summary and conelusion: A personal series of 220 eases of cesarean section by the lower-segment 'technique is reported and briefly analyzed. A consideration of this and othel':i'eported s&r1~s
611
Labor, Physiology, Management, Complications Ahumada, J. L., and Diradourian, J.: The Dangers of Infection Through Manual Removal of the Placenta, Arch. Clin. ob.st. y ginec. '' Eliseo Canton" 1: 792, 1942. The authors analyze 702 cases of manual removal of the placenta, from the Eliseo Canton. The ine.idence of manual removal at this institution was 1.33 per cent. The total mortality was 8.1 per cent, of which deaths from sepsis occurred in 3.3 per cent. The more infected the cases were at the time of manual removal, the graver was the prognosis. The authors therefore emphasize that, while thiB manipulation is relatively harmless in nonfebrile cases, it is serious in women who are infected. In view of this, the danger of manual removal of the placenta as an operative procedure has been greatly exaggerated. Because of this, a placenta should be removed early in the presence of serious ilemorrhage. J.P. GREENHII,L. Cootz, A. S.: Prognosis in Premature Rupture of the Membranes, Arch. Clin. obst. y ginec. "Eliseo Cant6n" 1: 818, 1942. Author maintains that premature rupture of the me~branes has an unfavorable prognosis because it results in interruption of gestation prematurely and it may lead to amniotic infection. Furthermore, the following disturbances may follow premature rupture: anomalies in uterine contraction, increase in eomplications of the third stage of labor, greater frequency of operative interference and unfavorable effect on the fetus. There is also an increase in morbidity and mortality during the puerperium. J.P. GREENHILL. Beruti, J. A.: Antispasmodic Treatment During Spontaneous Labor and Its Effect on the Fetus, Arch. Clin. obst. y ginee. "Eliseo Canton" 1: 699, 1942. Beruti administered spasmalgine and chloral hydrate to groups of women in labor and studied the effects of these drugs on the babies. In the cases of spontaneous labor, spasmalgine had no bad effects on the babies. In. a second group chloral hydrate was given to women who were having prolonged and difficult labor and again the babies fared well. The author compared the effects of spasmalgine and chloral hydrate and concluded that chloral hydrate is probably less harmful to the newborn than spasmalgine. J. P. GREENIULL. Biggins, L. G., F.R.C.S.: 1943.
Cesa,rean Section in Dystocia, Brit. M. J. 4285: 212,
Higgins suggests ''that the operation of Cesarean section involves less risk than difficult vaginal delivery, and that the indications for abdominal delivery may be considerably exttlnded with advantage to mother and child.'' He reports two series of personal eases, making 220 in all, which have been operated since 1931. One is a series of 157 elective operations; the other comprises 63 operations performed late in labor. He gives some statistics describing his operative technique, compares results with series of forceps deliveries, and closes with the following summary and conelusion: A personal series of 220 eases of cesarean section by the lower-segment 'technique is reported and briefly analyzed. A consideration of this and othel':i'eported s&r1~s