Woodard D. Beacham

Rupture of the uterus at New Orleans Charity Hospital

Part I of this continuing study consisted of the cases managed during a period of 37½ years and those in Part II embraced 18½ years. The incidence in the former was 1:1,328 deliveries and in the latter 1:1,951. During the last decade the ratio has been 1:2,531 deliveries. In Series A the maternal and fetal mortality rates were 47.9 and 79.6 per cent, respectively, while in Series B these figures were reduced to 8.9 and 52.4 per cent. Hemorrhage and shock claimed the lives of 22 mothers in the first group and 8 in the latter. Infection was the cause of death of 19 mothers in Series A but was not responsible for any in Series B. Emphasis is again placed on prevention, early recognition, and prompt individualized treatment.

Ectopic pregnancy at New Orleans Charity Hospital

S INCE the publication in 1921 of the excellent monograph on extrauterine pregnancy by Schumann, who served as president of the American (:ynecological Society in 1945 and 1946, the Transactions of that organization reveal that the current president, Rubin, reported at, the 1934 meeting on an analysis of 90 uterotubal insufflation cases showing the status of the residual tube following ectopic pregnancy in relation to sterility and further pregnancy. In 1939 Jones presented a paper, co-authored by John Brewer, the present secretary, on arterial phenomena associated with uterine. blcedirig in tubal pregnancy. At the meeting five years later Williams, president, in 1955, analyzed 101 fatalities from ectopic gestation. As shown by Table I this condition continues to take its toll. During the last five years for which the figures are available it was reported as the cause. of death in 868 cases, 416 of which patients were white and 452 were non-white.

Uterine and/or ovarian tumors weighing 25 pounds or more: A review of the literature in English since 1946☆

Abstract At the 1946 meeting of The Central Association of Obstetricians and Gynecologists, the patient with the 55 pound myomatous uterus managed on the Tulane Unit at the Charity Hospital of Louisiana at New Orleans was reported. The reasons for this communication are: first, to record the follow-up of that patient; second, to review the literature in English since then on uterine and/or ovarian tumors weighing 25 lbs. or more (11.37 kg.); third, to advocate that sizable tumors be coded in medical records so that data will be easily retrievable. In preparation of this paper we wrote to the chairmen of departments of obstetrics and gynecology listed in the 1968–1969 Association of American Medical Colleges Directory. Their replies indicate the necessity for such a procedure. This was further confirmed by the letters received from the members of the Conrad G. Collins Obstetric and Gynecologic Society of Tulane University.

Left renal agenesis, true unicornuate uterus, and total absence of left broad ligament, round ligament, salpinx, and ovary☆

Abstract Less than 30 cases of true unicornuate uterus with unilateral renal agenesis have been reported. Only one case of true unicornuate uterus with unilateral total absence of broad and round ligaments, salpinx, ovary, ureter, and kidney was recorded in the literature prior to this communication.

Surgical Treatment of Carcinoma in Situ of the Cervix Uteri

At the Congress of the International Federation of Gynecology and Obstetrics held in Vienna in 1961 the Cancer Committee under the chairmanship of Kottmeier defined stage 0, carcinoma of the cervix as preinvasive carcinoma, so-called carcinoma in situ. In 1964 the American College of Obstetricians and Gynecologists distributed Clinical Staging System for Carcinoma of the Cervix by the American Joint Committee for Cancer Staging and End Results Reporting. This Committee is sponsored by the American College of Surgeons, the American College of Radiology, the College of American Pathologists, the American College of Physicians, the American Cancer Society, and the National Cancer Institute. The brochure contained the above definition and designated the clinical stage as TO carcinoma in situ (intraepithelial). Its detection and eradication offer marvelous opportunity to prevent the havoc caused by invasive cancer. The advantages of treating any disease in its asymptomatic state is obvious.