TL;DR: This new procedure was also used for fetal head entrapment after vaginal breech delivery, and the authors report a review of the literature about this subject.
Abstract: The safety, predictability, and ease of intravenous administration of nitroglycerin (NTG) have been firmly documented. In recent years, intravenous NTG has come to the attention of the obstetrician as a potent uterine relaxant. Intravenous nitroglycerin has been used to relax the uterus during manual extraction of retained placenta and to permit replacement of a contracted, completely prolapsed, inverted uterus. The use of this agent as a tocolytic has previously been reported in cesarean delivery of twins, in cases of intra partum external cephalic version, and for internal intrapartum podalic version of the second twin. This new procedure was also used for fetal head entrapment after vaginal breech delivery. The authors report a review of the literature about this subject.
TL;DR: The general format of this book is well conceived and elegantly resolved, and the discussion, photographs, and illustrations of episiotomy and repair are outstanding.
Abstract: The general format of this book is well conceived and elegantly resolved. I encountered only a few misspelled words in the text. Specific comments follow. The forceps section is the outstanding example of this subject that I have encountered. Inclusion of the Task Force report on electronic fetal monitoring is innovative, but one wonders about its place in a surgical text. The section on cesarean hysterectomy contained several problems: the recommendation on page 637 that the baby is best delivered by breech extraction after podalic version if need be; absence of directions to the reader-surgeon to clamp paracervical and uterosacral tissues before their dissection from the uterus; the purse string reperitonealization of the pelvis, which, as the illustration clearly shows, brings the ovaries to a position right down on the vaginal cuff. The discussion, photographs, and illustrations of episiotomy and repair are outstanding. The Broedel illustrations of breech delivery, seemingly
TL;DR: From the experience, it appears that this modified technique, when used within the presented guidelines, offers a reasonable alternative for the safe delivery of the second twin.
TL;DR: It was confirmed that intravenous nitroglycerin (NTG) injection induces a transient and prompt uterine relaxation without affecting maternal and fetal prognosis.