Surgery, Gynecology & Obstetrics Volume 24 (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1917 Excerpt: ... President, Dr. Channtng W. Barrett, In The Chair. PITUITRIN IN LABOR Dr. Joseph B. De Lee: I would like to put on record a case that occurred recently at the Chicago Lying-in Hospital which will be very useful in judging of the dangers of pituitrin in labor. A woman with her second child had a very difficult instrumental delivery, which was followed, according to her statement, by peritonitis, from which she recovered after a long illness. In her third pregnancy a contracted pelvis was discovered and csesarean section at term just as labor began was recommended. She neglected to enter the hospital until well advanced in labor, and caesarean section was prepared for. Owing to an oversight, which was very fortunate in this particular instance, the preliminary injection of ergot was omitted. The abdomen was opened in the usual manner. The intention was to perform caesarean section by the suprasymphyseal transperitoneal method, as recommended by Doederlein and Kroenig. Upon opening the abdomen a haematoma was discovered under the bladder. We cut into it very rapidly and found the uterus had begun to rupture, an opening about two inches long having already occurred. The uterus was incised in the median line and a very deeply asphyxiated child extracted. The child was resuscitated successfully. The rupture extended to the right, into the broad ligament, under the base of the bladder, and had taken place in a scar composed of the lower uterine segment and the bladder-wall. It has been the practice of many physicians in performing caesarean section to give, in addition to the preliminary dose of ergot, a dose of pituitrin before opening the abdomen, and this case shows that had such a dose of pituitrin been administered, in all probability, when the incision was m...