Tocometry in obstetric practice: The development of a pneumatic system

Abstract

pregnancy is important in alleviating the need for prolonged confinement to bed for reducing the degree of cervical edema during labor.2 A normal spontaneous delivery may be anticipated in the majority of case+ 2 despite the elongated and edematous cervix genreally encountered. In view of shorter-than-normal duration of labor (averaging 6 hours in reported multiparasl and 8 hours in our primigravida), the utmost attention should be paid to possible precipitate delivery so as to prevent the common occurrence of cervical lacerations. In a rare occasion when rupture of the uterus might be feared in obstructive labor due to the rigid nonretractable cervix, a primary cesarean section would seem to be indicated rather than Dilhrssen’s incisions with their inherent complications. Although there have been no maternal deaths reported since 1925, the fetal mortality rate has remained unimproved at 18 per cent.2 With the advent of new diagnostic modalities for early detection of chronic and acute fetal distress, including repeated urinary and/or plasma estriol, continuous fetal heart rate monitoring, and frequent acid-base analyses of fetal scalp blood, assessment of the fetal condition during pregnancy and labor can be made more accurately than available heretofore. Future statistics in this respect can be expected to improve.