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Vaginal hysterectomy as the procedure of choice following previous abdominal pelvic operation has been evaluated. The source material comprised the case histories of 1,563 patients having vaginal hysterectomy between January, 1961, and January, 1971. Of these, in 942 no previous pelvic procedures had been done, and in 621 there was a history of one or more previous pelvic operations, including 48 abdominal suspensions and 56 cesarean sections. The indications for vaginal hysterectomy and the type of procedures performed were similar in both groups. These two groups were compared in terms of morbidity, major and minor complications, duration of hospitalization, frequency of morcellation, transfusion rate, and the postoperative decrease in hemoglobin. Analysis of these results provides the basis for our conclusion that vaginal hysterectomy is not contraindicated per se after previous abdominal pelvic operations.

Blood-volume was determined in three hundred and one healthy full-term infants after their cords were clamped at different time-intervals after birth. The infants were divided into two groups, depending on whether the mothers received intravenous methylergometrine during the early third stage of labour or not. The results demonstrated that postnatal transfer of the placental blood to the baby took place at a rapid rate and in a stepwise manner, amounting to about 55% of the baby's blood-volume at birth. This stepwise and rapid rate of placental transfusion correlated with the time of uterine contraction during the third stage of labour. In relation to the uterine contraction at birth, about 23-30% of the blood was transferred during the first 10 to 15 seconds. The remaining 70-77% of blood transfer in the non-methylergometrine group was effected partly at 1 minute and completely at 3 minutes after a uterine contraction, whereas in the methylergometrine group, placental transfusion was accelerated, and the remaining 70-77% of blood was almost completely transferred at 1 minute owing to an earlier and enhanced uterine contraction which, it is suggested, plays a key part. No direct significant influence of respiration on placental transfusion was demonstrated.