Placenta praevia / by G.M.B. Maughs.

  • Maughs, G. M. B. (George Madison Brown), 1821-1901.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Placenta praevia / by G.M.B. Maughs. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    19/27 (page 16)
    the largest size sponge tent that will be admitted should be dipped in carbolated glycerine and introduced in the cervix, or, instead, three or five or more laminaria tents ; these should be held in place by a pledget of cotton saturated with glycerine. Of course there is no hiemorrhage now, and labor ])ains, if pres- ent, are greatly intensified, if absent, are sure to be induced, while the tents perform the double i)urpose of stopi)ing the discharge and assisting, hastening, forcing the first stage of labor, dilatation of the os. If all goes well, as it most likely will, the tents may be permitted to remain several hours, or until labor j)ains are urgent, when they may be removed, two fingers in- troduced into the uterus, and swej)t around, separating the placenta from the lower segment, and the membranes ruptured at any point when the fingers reach the i)laceutal margin. At this time the presentation of the ftetus should be ascertained and if untoward correeted by bringing down the head or a foot. This can nearly’ always be done at this time by the bipolar method. Give now ji. Squibb’s fluid ext. ergot, and if there is no hremorr- hage and the i)ains urgent, we may trust to nature, carefully watching the case. If the luemorrhage continues, or returns, for it is well to know that while this will most probably be ar- rested by the artificial dilatation of the os, the partial separa- tion of the placenta and rupture of the membrane, yet it may not be, if still present then and the os be sufficiently dilated or dilatable, we may proceed to extract the child, with the forceps if the head is presenting, if any other presentation by the feet. In either case u.sing only so much vis u frontc as may be neces- sary to suppliment the deficient rin a Itryo, being careful to have the contracted uterus follow down the retreating foetus, and this, more es])ecially, if there be signs of failing strength, ex- haustion, as evidenced by a small, frequent pulse, paleness, etc. The placenta most generally follows immediately, a comj)ress should be carefully adjusted, and laudanum, brandy and beef tea administered if necessary, and the patient w'atched until fully recovered from apy unusual depression. If in this case the haunorrhage had been urgent but had ceased at the time of our arrival, we may commence with the tents. It may be asked, “why not do so in the first place?” We most likely may not have them with us, and their adjustment requires time, meanwhile the woman is bleeding, to stop this and husband her strength, we resort to the tampon as an