. The Cleveland medical journal . was of the opinion that many of the bad results frompremature labor were from improper technic. He employedbougies only in primiparae with flat pelves and vertex presenta-tions, and in multiparae with generally contracted pelves and ver-tex presentations. For the other cases he used the metreurynter. The second of the prophylactic operations is prophylacticversion, a procedure based upon the fact that the aftercominghead can more readily overcome pelvic contracture than the fore-coming head. In this operation the distinct difference betweenindicated version an
. The Cleveland medical journal . was of the opinion that many of the bad results frompremature labor were from improper technic. He employedbougies only in primiparae with flat pelves and vertex presenta-tions, and in multiparae with generally contracted pelves and ver-tex presentations. For the other cases he used the metreurynter. The second of the prophylactic operations is prophylacticversion, a procedure based upon the fact that the aftercominghead can more readily overcome pelvic contracture than the fore-coming head. In this operation the distinct difference betweenindicated version and prophylactic version must be borne in former operation is indicated because of same representa-tion, while the latter is indicated because of the contracted pelvisper se. Following 95 prophylactic versions there was an infan-tile mortality of 21%, and a maternal mortality of , which isindeed not nearly as good a result as obtained by other methodsof delivery. °lo0 7 2 3 k 6 6 7 V I 10 II II Id Ijt IS lb II W ft 10. Fig. 2. Results from Prophylactic Measures in Contracted Pelvis. (In those clinics ii which prophylactic measures were least employed themortality, both fetal and maternal, was lowest). The usual indication given for the performance of prophy-lactic version is in multiparae with contracted pelves and cm. C. V. when the fetal head is not too lanje. RoucK—Labor in Contracted Pelvis 109 Prophylactic version gives better results when performed in casesof flatly contracted pelves (18% infantile mortality) than whenperformed in generally contracted pelves (28% infantile mortal-ity). It is more favorable in multiparae because of the relaxedconditions of the uterus and soft parts. In order to determinewhether with this operation improved results are obtained for botrimother and child, as against the expectant plan of treatment,Burger estimates the results obtained in the same class of cases(multiparae) with flat pelves, C. V. to cm.,
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectmedicine, bookyear191
