The induction of premature labour / Clement Godson.

  • Godson, Clement, 1845-1913.
Date:
[1875]
Catalogue details

Licence: Public Domain Mark

Credit: The induction of premature labour / Clement Godson. Source: Wellcome Collection.

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    punctured while pressing it. These should be improbable conse¬ quences, and I believe it to be one of the best methods which we have ; for, should it fail, it may be followed up by the insertion of sponge tents. 10.,In America, the term ‘ colpeurysis ’ is used to signify dilata¬ tion of the vagina, and a vulcanised gum-elastic bag called Braun’s colpeurynter has been employed to dilate the vagina, with the view of setting up uterine action. While stretching the vagina, it is supposed to act also upon the os uteri, and Dr Meigs* says it is found that about four hours suffice to dilate the os uteri sufficiently to provoke good labour pains. I do not know that it has ever been carried into practice in this country. 11. Dilatation of the os uteri by elastic bags was proposed by Dr Keiller, and has been brought prominently forward of late years by Dr Barnes, who has introduced an improved form of bag for the purpose. Speaking of the different methods for provoking the uterus into action, Dr Barnes f says, ‘Now, active labour may come to pass in twelve or twenty-four hours, or in two, three, four days, or even later. There is no certainty about it. When labour comes, the child is expelled with little warning, almost suddenly, and before the medical attendant can be fetched. And it has to run the gauntlet of all those perils which especially surround premature labour unaided. It is just as feasible to make an appointment at any distance from home, to carry out at one sitting the induction of labour, as it is to cut for the stone/ Dr Barnes puts in an elastic bougie over-night, which, he says, gives rise to uterine action; next day he introduces his bags. Uterine action has been set up by the bougie, in other words, labour has commenced; why then in¬ terfere with a process which, started artificially, may be completed gradually by the efforts of nature ? If this argument of carrying out the process of labour ‘ at one sitting, as one would cut for stone/ applies in premature labour, why should it not in labour at full term ? If not likely to be followed by evil consequences, it would be a great boon to the medical attendant. To be kept about by a patient whom one has found in the first stage of labour is extremely trying. How much time and annoyance would be saved if we could proceed at once to ‘ carry out at the one sitting ’ the delivery ! And I cannot see why it should apply in one case more than in the other. Barnes’ bags are of the utmost value when it is desirable to complete the labour in as short a time as possible— for instance, in puerperal convulsions ; but in induction of prema¬ ture labour, for causes not requiring hurry, to my mind their * Treatise on Obstetrics, Philadelphia, 1863, 4th edit, p. 584. t Lectures on Obstetric Operations, 2d edit. p. 363.
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