A review of 2000 consecutive forceps deliveries

Two thousand forceps deliveries done at the Philippine General Hospital from October 1945 - January 1951 were reviewed. The indications, conditions, and contra-indications for forceps operations were analyzedA total of 1,404 low forceps (70.2%), 569 midforceps (28.4%) and 27 high forceps (0.1%) were noted. Indicated forceps occurred in 995 cases (49.8%) and non-indicated forceps in 1,005 cases (50.2%). Maternal indications (948 cases) were the most frequent causes for the operation while fetal indications (47%) were rare causesLess complications were noted in low operations than in the higher types of operations. The most serious complications were rupture of the uterus, deep perineal tears, and cervical tears. Morbidity was found related with the type of operation. Fifteen maternal deaths caused by midforceps in eight cases and by low forceps in 7 cases were observed. Uncorrected maternal mortality was 0.75% while corrected mortality was 0.1%Two forceps operations were presented with poor results. Adequate prenatal and natal care were deemed neededThe study indicated that high forceps should be condemned and that midforceps be avoided

Early diagnosis of pelvic malignancies

A short narration has been given to orient the general physician on his role in early detection of pelvic malignancy, his position being on the first line of attack. The what, how, where and why of this problem have been presented briefly. (Summary)

Widening the indications for cesarean section

1. A review of cesarean sections done at the Philippine General Hospital during two separate periods is made, to indicate the increasing incidence and scope of cesarean section2. The effects of the broadening scope of cesarean section on the hemorrhages are shown, particularly on maternal and infant mortality3. The ill-effects of the broadening scope of cesarean section is shown on the incidence of rupture, and incidence of sterilization on 117 primary sections out of 773 sections done at the Philippine General Hospital from 1945 to the close of 19514. Our conclusion is that the immediate good effects outweigh the remote ill-effects of the obstetric cripple, since these are preventable by good skill and judgment on the lst section, massive antibiotics and blood transfusion to aid in the healing and prophylactic measures on all previous sectioned cases5. While the good results justify the broadening of the indications for the operation, there is a tendency to abuse the operation in preference to vaginal delivery; but this tendency can be controlled through good obstetric judgment and an honest conscience. (Summary and conclusions)

An epidemiologic study of trophoblastic diseases

Five hundred and eighty-one cases of hydatidiform mole from the Maternity and Childrens Hospital from 1961 through 1966 were compared with 2285 controls drawn from the same hospital. The cases were older and had higher gravidity and parity than the controls. There was, however, a higher proportion of cases than controls among nulliparae. No definite association between hydatidiform mole and previous abortion was found. Cases of hydatidiform mole had a risk of one out of ten of being associated with chorionic malignancy. Cases 35 years or older had a risk 2.74 times that of younger cases, gravida IV or more had 2.60 times the risk of gravida I-III, and para III or more, 2.69 times of Para 0-2