William C. Keettel

Factors influencing lesbian gynecologic care: A preliminary study☆

One hundred seventeen homosexual women were surveyed to determine their health care utilization patterns, their gynecologic and obstetric problems, and their attitudes toward physicians. It was found that these women actively utilized the health care system, although many chose less traditional sources. The gamut of both obstetric and gynecologic problems were seen, but venereal disease and cervical dysplasia were uncommon. No medical problems specific to homosexual women were identified. Many of these lesbians expressed concern about the effect on their health care of physicians negative attitude toward homosexuals.

Maternal mortality in a major referral hospital, 1926 to 1980

This review describes the changes in the causes of maternal deaths in a major referral hospital over a span of 55 years. There has been a significant decline in direct maternal deaths from infection, hemorrhage, and toxemia. Continued vigilance is needed since 58% of direct obstetric deaths in our hospital during the last 30 years were considered to have been preventable. Heart disease and nonobstetric infection as indirect causes of maternal deaths have decreased also. Greater effort is necessary to identify those patients with conditions that predispose to indirect deaths and to provide appropriate contraception, sterilization, early pregnancy termination, or optimal multidisciplinary care in a referral hospital.

Prolapse of the uterus associated with pregnancy

Abstract Four cases of prolapse of the uterus associated with pregnancy are presented. These occurred among 16,542 obstetrical admissions at the University Hospitals, Iowa City, Iowa, between July, 1940, and January, 1956. Eighteen other cases occurring in the same years were collected from the literature. In recent years, there has been a shift toward conservative treatment. Pessaries, bed rest, vaginal packs, and perineal pads were the treatments of choice. The frequency of abortion was much less than previously reported. There were no maternal deaths reported. The fetal death rate was quite low. The puerperium was normal in all cases; there was no puerperal morbidity or other complications. One may attribute this improvement to the advent and use of antibiotics and the conservative treatment used by different authors.