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Frederick H. Falls, M.D.
JAMA. 1958;166(12):1409-1412. doi:10.1001/jama.1958.02990120001001.
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Five hundred cesarean operations were done by the same surgeon using alternately the classic technique and the low cervical technique with longitudinal incision. No significant differences could be observed in the results for either mother or baby. The transverse incision is deprecated because of the danger of hemorrhage. The cesarean operation should be done promptly if a patient with toxemia does not improve within 72 hours under strict medical management. Toxemia management must be continued after operation until albuminuria and hypertension have subsided and urinary output is satisfactory. Bicornuate uterus and related anomalies should be kept in mind as possible causes of many varied obstetric difficulties. Infected abortions, ectopic pregnancy, and sterility still are important problems in obstetric surgery. In gynecologic surgery many important questions remain unanswered, especially relating to uterine carcinoma, ovarian carcinoma, and leiomyomas. Difficulties of diagnosis arise from the fact that the symptoms of a fibroid tumor may be little affected by the presence or absence of an associated malignancy and that the combination of ectopic pregnancy and fibroid tumors is not uncommon. If intra-abdominal hemorrhage is strongly suspected in a woman with a fibroid tumor, immediate operation is recommended.


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