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The selection of twelve patients with urinary stress incontinence forms the basis of this study. Simple vesicourethral suspension as described by Marshall and his co-workers was the procedure used to correct their complaint. An evaluation of the clinical and anatomical findings observed before correction, particularly with the aid of cystography, showed that failure of the pelvic floor, especially of the levator ani, to support the vesical sphincter mechanism was most frequently associated with loss of urinary control. Cystography postoperatively revealed the striking degree of elevation of the bladder and its outlet effected by the operation. It further demonstrated that the procedure fixes the urethra to the posterior surface of the symphysis without distortion. Although suprapubic vesicourethral suspension is not meant to supplant the standard vaginal operations for the relief of stress incontinence, some of the advantages are enumerated. It is indicated, as a result of this study, that the mechanism of the operation's success lies in the fact that it restores a relatively firm point of attachment to the sphincter mechanism of the vesical neck, a major requirement for the normal function of any sphincter.

In this presentation we propose to evaluate and comment upon the facts which have been accumulated from our experience with ectopic pregnancy. The importance of such a study becomes apparent in the light of Williams and Corbit's recent analysis of 101 fatalities from ectopic pregnancy. These authors state that in the decade 1931 to 1940 every eighteenth puerperal death in Philadelphia, every sixteenth puerperal death in New York City, and every twelfth puerperal death in Chicago was due to ectopic gestation. In Philadelphia from 1931 to 1943 the mortality was 4.6 per cent. Within the last ten years reports on the mortality rate have ranged from 3.2 per cent to 8.3 per cent; Fitzgerald and Brewer, 7.8 per cent 1935; Falk and Rosenbloom, 8.3 per cent 1936; Ware and Winn, 8 per cent 1941; Farrell and Scheffey, 3.2 per cent 1943; and Siegler, 3.9 per cent 1945.

The fourth case of thrombotic thrombocytopenic purpura complicating pregnancy has been reported, the subject briefly reviewed, and therapy discussed as to the advantages and disadvantages of medical versus surgical treatment.