Operative obstetrics including the surgery of the newborn / by Edward P. Davis.

  • Edward P. Davis
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: Operative obstetrics including the surgery of the newborn / by Edward P. Davis. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    sac and above the placenta. It is estimated that a pressure of 1 kilo can thus be exerted. Every effort should be made to secure the spon- taneous expulsion of the bag, when the operator can proceed to ter- minate labor, usually by version and extraction. The results of the so-called conservative methods of treating placenta prsevia in recent years may be estimated from Novak's extensive review of the subject (Monatsschrift f. Geburtshiilfe und Gynakologie, Band 30, Heft 2, 1909). From the simple procedure of rupturing the membranes in partial placenta prsevia, and allowing uterine contractions to compress the placenta, he finds 163 cases reported by different authors, with no maternal mortality. The mortality among the children at birth was 25, or 15.3 per cent. This represents the simplest forms of placenta prsevia and the simplest available treatment which is sufficient for the mother, but attended by considerable fetal mortality. In addition to the children still- born a considerable number of those living at birth die soon afterward from weakness. When version and extraction were practised he found in 878 cases reported by different authors a maternal mortality of 8.8 per cent, and a fetal mortality of 71.8 per cent. Weischer, in Olshausen's clinic in Berlin (Zeitschrift f. Geburtshiilfe und Gynakologie, Band 67, Heft 2, 1910), in com])ined version had a maternal mortality of 7.4 per cent, and a fetal mortality of 74.1 per cent. Other authors report slightly different mortality rates for this method of treatment, but the general result is much the same. By the use of dilating bags Weischer's maternal mortality was 8.5 per cent, and the fetal mortality 46.8 per cent. Hammerschlag, Hannes, and Burger-Graf had a maternal mortality of 5.8 per cent.; Zimmermann, 6 per cent.; Hoist, 12.5 per cent., and Sigwart, in 33 cases treated by the use of bags, had no maternal mor- tality. In fetal mortality, Thies had 14 per cent.; Diihrssen, 16.6 per cent.; Freund, 20 per cent.; Hannes, 30 per cent.; Keetman, 50 per cent.; Zimmermann, 62 per cent.; Hoist, from 60 to 65 per cent.