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Cesarean Birth and Silver Nitrate Prophylaxis

James R. West, MD
JAMA. 1972;220(1):128. doi:10.1001/jama.1972.03200010112032.
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To the Editor.—  The LAW AND MEDICINE section of The Journal (219:129, 1972) includes the statement that "the baby had been born by cesarean, thus obviating the necessity for drops"—referring to silver nitrate prophylaxis against ophthalmia neonatorum.It is of interest that the 3rd edition of Stander's Textbook of Obstetrics (New York, Appleton-Century, 1945) carries the observation on p 460:We have recently seen a case of specific ophthalmia develop in spite of the use of prophylactic measures, in an infant born by Caesarean Section. In such cases the infection develops while the child is still in utero, and Stephenson states that it may occur without premature rupture of the membranes, having been noted in a child born in a "caul". In view of the possibility of infection occurring in this way it is imperative that prophylactic measures be employed in infants born by Caesarean Section.The implication in


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