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Use of the vacuum extractor
Volume 87 Number 8
Marshall: Thermal Changes in the Normal Menstrual Cycle, p. 102. Daily basal body temperature records were kept by 155 consecutive women of proved fertility, who provided temperature charts for 1,134· cycles. The frequency distribution curve for cycle length showed a mode of 28 days, with only slight differences in the number of 26, 27, and 28 day cycles. A thermal shift was evident in 1,088 cycles; 20 cycles were considered anovulatory on the basis of temperature graphs. The character of the temperature rise was acute in more than 80 per cent of the cycles showing a thermal shift. The postovulatory phase, from the onset of the temperature rise to the onset of the subsequent menstrual flow, showed a mode of 13 days with 67 per cent of cycles falling between 11 and 14 days. Of those cycles considered ovulatory, 17.6 per cent had a postovulatory phase length of less than 11 days. Although the length of the postovulatory phase is relatively fixed, there was a tendency toward a progressive increase in length of this phase \vith increasing cycle length. Edward E. Wallach Lancet: Use of the Vacuum Extractor, p. 165. Experience with the vacuum extractor (V.E.) in 81 consecutive nonselected cases is reviewed. The most frequent indication for its use was a prolonged second stage of labor. Inasmuch as the V.E. vvas applied in some cases prior to full dilatation of the cervix, prolongation of the first stage was the second most frequent indication. In 11 cases the fetal head was in the high-plane of the pelvis at the time of application. The V.E. was used to increase the force and length of labor contractions in 37 patients who had inadequate response to stimulation by oxytocin and/ or pethidine infusion. Slight sc~lp excoriations not necessitating treatment were noted in about 50 per cent of the infants during the first two postnatal days, but all the babies seen at 1 month of age were found to be completely normal. Neither of the two neonatal deaths in the series could be attributed to the vacuum extractor; the third perinatal death occurred in a case in which the instrument was applied to the breech of an already dead fetus. Episiotomy was liberally employed. Maternal morbidity was somewhat reduced in the V.E. group as compared with a group of 79 forceps deliveries. General anesthesia was not used, anesthesia being limited
Selected abstracts
1099
to pudendal block or local infiltration with 1 per cent procaine. The authors feel that the vacuum extractor is a versatile instrument which can replace the forceps in almost any of its indications, except for face presentation and aftercoming head. Edward E. Wallach
Egeberg and Owren: Oral Contraception and Blood Coagulability, p. 220. Several parameters of blood coagulability were investigated in ten normal, healthy women, five of whom received Enovid, 5 mg. a day from day 5 to 24 of the menstrual cycle, and 5 of whom were untreated controls. Studies throughout the cycles revealed a shortening of the cephalin time and an increased activity of antihemophilic A factor. (Factor VIII), with a slight increase in proconvertin (Factor VII) activity in women treated with Enovid. These changes developed during the first 2 weeks of therapy, and tended to return to pretreatment levels soon after the drug was stopped. No significant changes \vere noted in the prothrombin time, Christmas factor (Factor IX), P. T. A. (Factor XI), proaccelerin (Factor V), prothrombin (Factor II), or fibrinogen time. There were no significant alterations observed in the coagulability studies among the control patients throughout the normal menstrual cycle. Edward E. Wallach
February, 1963. *Shearman, R. P., and Garrett, W. ]. : Dou~le blind Study of Effect of 17-Hydroxyprogesterone Caproate on Abortion Rate, -
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L;:JL;.
*Taylor, A. I.: Nuclear Sex of Embryonic Tumors, p. 377.
Shearman and Garrett: Double-blind Study of Effect of 17-Hydroxyprogesterone Caproate on Abortion Rate, p. 292. The purpose of this study is to evaluate progestogen therapy in patients with a history of abortion. Fifty patients were selected for treatment on the basis of: ( 1) history of 2 or more consecutive abortions, and (2) a low or falling urinary pregnanediol level in comparison with the values of a normal curve. A double-blind study is being employed to determipe the effect of 17-hydroxyprogesterone caproate on abortion rate. A placebo, identical in appearance and
Marshall: Thermal Changes in the Normal Menstrual Cycle, p. 102. Daily basal body temperature records were kept by 155 consecutive women of proved fertility, who provided temperature charts for 1,134· cycles. The frequency distribution curve for cycle length showed a mode of 28 days, with only slight differences in the number of 26, 27, and 28 day cycles. A thermal shift was evident in 1,088 cycles; 20 cycles were considered anovulatory on the basis of temperature graphs. The character of the temperature rise was acute in more than 80 per cent of the cycles showing a thermal shift. The postovulatory phase, from the onset of the temperature rise to the onset of the subsequent menstrual flow, showed a mode of 13 days with 67 per cent of cycles falling between 11 and 14 days. Of those cycles considered ovulatory, 17.6 per cent had a postovulatory phase length of less than 11 days. Although the length of the postovulatory phase is relatively fixed, there was a tendency toward a progressive increase in length of this phase \vith increasing cycle length. Edward E. Wallach Lancet: Use of the Vacuum Extractor, p. 165. Experience with the vacuum extractor (V.E.) in 81 consecutive nonselected cases is reviewed. The most frequent indication for its use was a prolonged second stage of labor. Inasmuch as the V.E. vvas applied in some cases prior to full dilatation of the cervix, prolongation of the first stage was the second most frequent indication. In 11 cases the fetal head was in the high-plane of the pelvis at the time of application. The V.E. was used to increase the force and length of labor contractions in 37 patients who had inadequate response to stimulation by oxytocin and/ or pethidine infusion. Slight sc~lp excoriations not necessitating treatment were noted in about 50 per cent of the infants during the first two postnatal days, but all the babies seen at 1 month of age were found to be completely normal. Neither of the two neonatal deaths in the series could be attributed to the vacuum extractor; the third perinatal death occurred in a case in which the instrument was applied to the breech of an already dead fetus. Episiotomy was liberally employed. Maternal morbidity was somewhat reduced in the V.E. group as compared with a group of 79 forceps deliveries. General anesthesia was not used, anesthesia being limited
Selected abstracts
1099
to pudendal block or local infiltration with 1 per cent procaine. The authors feel that the vacuum extractor is a versatile instrument which can replace the forceps in almost any of its indications, except for face presentation and aftercoming head. Edward E. Wallach
Egeberg and Owren: Oral Contraception and Blood Coagulability, p. 220. Several parameters of blood coagulability were investigated in ten normal, healthy women, five of whom received Enovid, 5 mg. a day from day 5 to 24 of the menstrual cycle, and 5 of whom were untreated controls. Studies throughout the cycles revealed a shortening of the cephalin time and an increased activity of antihemophilic A factor. (Factor VIII), with a slight increase in proconvertin (Factor VII) activity in women treated with Enovid. These changes developed during the first 2 weeks of therapy, and tended to return to pretreatment levels soon after the drug was stopped. No significant changes \vere noted in the prothrombin time, Christmas factor (Factor IX), P. T. A. (Factor XI), proaccelerin (Factor V), prothrombin (Factor II), or fibrinogen time. There were no significant alterations observed in the coagulability studies among the control patients throughout the normal menstrual cycle. Edward E. Wallach
February, 1963. *Shearman, R. P., and Garrett, W. ]. : Dou~le blind Study of Effect of 17-Hydroxyprogesterone Caproate on Abortion Rate, -
!-'·
()(11')
L;:JL;.
*Taylor, A. I.: Nuclear Sex of Embryonic Tumors, p. 377.
Shearman and Garrett: Double-blind Study of Effect of 17-Hydroxyprogesterone Caproate on Abortion Rate, p. 292. The purpose of this study is to evaluate progestogen therapy in patients with a history of abortion. Fifty patients were selected for treatment on the basis of: ( 1) history of 2 or more consecutive abortions, and (2) a low or falling urinary pregnanediol level in comparison with the values of a normal curve. A double-blind study is being employed to determipe the effect of 17-hydroxyprogesterone caproate on abortion rate. A placebo, identical in appearance and