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Although the trend in the recent literature is toward an increase in the incidence of cesarean section, mainly due to the addition of new indications, we have found a slight decrease in our section incidence in the last 5 years. Such indications as contracted pelvis, cephalopelvic disproportion, toxemia, and intercurrent disease showed a total decrease of 18 per cent in the past 5 years. We believe that this has resulted from more careful evaluation of our indications and from compulsory consultation by 2 qualified obstetricians before section is done. A thorough discussion of the indications for each section at the weekly staff conferences has further tended to reduce sections done for tenuous indications. Operations performed for the indication previous section were increased by 17 per cent in the past 5 years. It may be that the increasing number of low cervical sections may be a factor in permitting more patients to deliver vaginally rather than performing repeat sections. Such indications as dystocia due to faulty presentation or tumors, hemorrhage, and miscellaneous indications have shown no change in their incidence of section over the past 15 years. It is our belief that the judicious use of intravenous Pitocin has resulted in vaginal deliveries in many patients who previously might have come to section. We have found it extremely useful in patients with uterine inertia and in patients with hemorrhage where conditions for vaginal delivery exist but where delivery must be brought about rapidly. We have also noted a tendency to attempt induction with Pitocin in toxemic patients in whom we previously might have thought that labor could not be induced. Even when the Pitocin induction was not successful on the first attempt it usually resulted in vaginal delivery on a subsequent attempt the following day. We have also used Pitocin in patients in whom the question of slight cephalopelvic disproportion existed and in whom we felt an adequate trial of labor was indicated. With the more forceful uterine contractions produced by Pitocin, we have been able to evaluate such a patient within one to two hours as to the possibility of vaginal delivery. We have noted no untoward effects from this procedure and have frequently saved the patient from an unnecessary section.

1. 1. Four cases of severe postpartum bleeding associated with coagulation defect are presented. 2. 2. Transient hypofibrinogenemia was present in all patients at the height of the bleeding diathesis. 3. 3. The serum of one patient showed transient but marked fibrinolytic activity. 4. 4. In two patients, transient thrombocytopenia was noted. 5. 5. Intravenous fibrinogen caused prompt return of the coagulation mechanism to normal. 6. 6. The removal of the uterus and its contents does not ensure rapid correction of the coagulation defect. Additional fibrinogen is frequently necessary. 7. 7. All patients in whom a diagnosis is made of severe toxemia of pregnancy, premature separation of the placenta, marked isoimmunization in pregnancy, presence of a dead fetus, or severe hepatic damage should be screened for the possible development of afibrinogenemia at the time of delivery.

1. A preliminary study with a new water-soluble medium, Medopaque-H, in 50 cases of hysterosalpingography is presented. 2. Medopaque-H appears to meet the requirements of being a harmless radiopaque medium, innocuous to the pelvic organs, and rapidly absorbed. 3. A combined technique for hysterosalpingography, using fractional instillations of Medopaque-H followed by carbon dioxide insufflation, is described, thus eliminating need for a 24 hour plate.

1. 1. A case of acute anterior bulbospinal poliomyelitis complicated by a fulminating toxemia of pregnancy is presented. 2. 2. Termination of the pregnancy was effected by the use of Pitocin induction and forceps delivery accomplished within the respirator.

1. 1. A case study of acute blindness complicating pregnancy is discussed. 2. 2. A review of world literature on the subject is presented. 3. 3. Various forms of therapy are mentioned.