20 The Philippine Journal of Science 1920 
mately connected with that of the mother. Briefly summarized, 
this examination should include the following points: 
a. Early and complete physical examination of the pregnant 
woman, especially of the heart, the lungs, the abdomen, and the 
blood pressure. 
b. Pelvimetry and cephalometry before the eighth month in 
primipara in order to ascertain the size of the fetal head and 
the relative capacity of the birth canal. 
c. Examination of the urine every four weeks during the 
first six months of pregnancy, and every two weeks, or oftener 
if necessary, thereafter. 
d. Wassermann reaction in suspected cases. 
e. Examination of the fetal presentation and auscultation of 
its heart sounds. 
/. History of previous pregnancies and labors. 
From the results of these different examinations one must 
decide the line of treatment adapted to each particular case, 
not only to combat whatever complication may endanger the 
life of the mother, but also to insure the birth of a sound baby. 
Although it is not my intention here to present these different 
complications and their treatment, I might emphazise the fact 
that a good many abortions and fetal macerations of luetic 
origin could be averted if adequate treatment were instituted 
early. 
Through intranatal care, which consists essentially of a proper 
conduct of labor, normal or otherwise, it will be possible to save 
many lives, for it is a well-known fact that, as macerated 
fetuses die on account of some disease of the placenta, 
retroplacental hemorrhages, chronic kidney diseases, syphilis, 
or other maternal diseases, fresh or nonmacerated fetuses are 
likewise prone to die on account of some accident of labor, 
traumatic or otherwise, such as placenta previa, accidental 
hemorrhages, umbilical prolapse, or unduly prolonged labor. 
This statement is borne out by the fact that more than half of 
the fresh fetuses that are delivered stillborn show lesions of 
cerebral hemorrhage and lacerations of the dura mater from 
excessive or prolonged pressure, injuries which a competent 
obstetrician might have easily prevented. 
I shall not discuss here the different indications which the 
obstetrician must meet according to the different complications 
that may develop in every delivery, but I shall call your atten- 
tion to the indication of premature delivery or Cesarean section 
in women with narrow pelves. In these cases the fetuses, left 
