Evening star., 1942-02-21
Fewer MortaIhies
Seen With Advances
In Obstetrics
Amnesio Methods Cited
At POSTGRADUATE Clinic Of
6. w. U. Medical School

Notable advances in the science
Of obstetrics which may result in
. lower maternal mortality and
fewer still births were described
before the postgraduate clinic of
George Washington University med
ical school here today by DR.. Clif-
J ford B. Lull of the Jefferson Medical
College, Philadelphia.
DR.. Lull spoke specifically on the
use Of analgesic agents to reduce
the pains Of childbirth.
In spite Of claims to the contrary,
he said, absolutely safe and painless
labor still Is impossible. But, he ex-
planned, at least 30 per cent am
nesia can be produced by the skilled
obstretrician in the proper surround
ings. This means, he stressed,
. hospital with q welI-equipped
obstetrical service: Use Of pain
killing drugs usually Is not advis-
able in the home.
Proper Training Necessary.
The drugs now generally used.
DR.. Lull said, are the so-called
barbiturates-sodium amytal, nem-
burial and paradehyde. 1t Is inad-
visable even for the skilled obste-
trician to use them, he insisted,
until the process of labor Is well
advanced. Otherwise the physician
runs the risk of defeating his own
purpose. The prospective mother
falls asleep. The birth process stops.
1t must be endured all over again
when the effect Of the drug wears
of. Another result, he said, is the
increased number Of instrumental
deliveries which may cause perna-
nent injury to the child.
The barbiturates, DR.. LulI. said,
have largely taken the place of the
old mixture of morphine and scopo-
lomine-known as twilight sleep
which came into obstetrical prac-
tice about 20 years ago. The great
danger, he stressed, is that the
unborn child Is drugged as well
as the mother. 1t comes into the
world asleep and the physician may
be unable to waken 1t.
Two Developments Cited.
Probably the two most notable
advances in recent years, DR.. LuH
said, are:
First. ewly-developed technique
by which drugs can be injected
directly into the bloodstream of the
mother which will produce uterine
contractions in about 20 seconds
and thus prevent hemouhages
which in the past often have been
serious.
Second, new technique by which
Caesarian operstions can be per-
formed after the lsbor process has
actually started. Hitherto this has
been impossible, or at best very
dangerous. because Of the probable
ity OF peritonitis.
The process Of childbirth, he ex-
planned, involves at least a mild
degree of infection. 1t usually Is
accompanied by a low fever. When
the obsterician takes the chance of
adding to the infection already
present by cutting through tthe
peritoneum to open the uterus, he
Is inviting disaster.
But with the new technique the
peritoneum is entirely avoided. 1t
is possible to wait until 1t Is certain
a normal birth cannot take place.
Other speakers on the program
arranged by the A. F. A. King OBJ
stetrical Society were DR.. Samuel
M. Dodek Of the George Washington
faculty, DR.. Robert A. Ross of the
University of North Carolina and
DR.. Frederick H. Falls Of the Uni
versity Of Illinois.
Advances in the treatment of dia-
betes ~ere described by DR.. Elliott
P. Joslin of Harvard medical school.