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To the Editor:
—I wish to comment on Dr. Greenhill's reply concerning the article on intra-uterine death, which appeared in the "Questions and Answers" section of the Sept 15 issue of The Journal (181:1021). I have had an excellent experience with transabdominal amniotic puncture and the filling of the amniotic sac with about 200 ml of sterile 20% saline solution. The procedure is simple, can be done under a local anesthetic (or even without an anesthetic), and produces a spontaneous delivery in 16 to 24 hr. The delivery itself is easy because of the small size of the fetus, no retention of placenta, and no excessive bleeding. I had eight cases of missed immature deliveries, and all eight of them responded promptly and without complications. The method has been described recently by Jaffin; Kerenyi; and Wood: Amer J Obstet Gynec, vol 84, Sept 1,1962.This letter was referred to
Ladislao J. Prazak. Intra-Uterine Death. JAMA. 1963;183(8):715. doi:10.1001/jama.1963.03700080123036