Obstetric aphorisms : for the use of students commencing midwifery practice / by Joseph Griffiths Swayne.

  • Swayne, Joseph Griffiths, 1819-1903.
Date:
1913
Catalogue details

Licence: In copyright

Credit: Obstetric aphorisms : for the use of students commencing midwifery practice / by Joseph Griffiths Swayne. Source: Wellcome Collection.

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    niaindor gradually and cautiously separated by the fingers from the uterus until the whole can bo removed. These operations require much tact and delicacy. The introduc- tion of tho hand into the uterus is a measure always attended with some risk, but tho operation liecomcs doubly hazardous when the placenta is morbidly adherent. There is then tho danger of injuring tho uterus, as well as of leaving portions of adherent placenta boliind. These ojiora- tions should never bo attempted by the student except in extreme cases, as, for instance, when there is a profuse ha:mon-hage, and no assistance .at hand. Profuse lioemor- rhage generally means partial detachment of the placent.a. A completely .adherent pl.acenta does not give rise to hiemorrhage, and if this last be absent, the retention of the placenta need give rise to no alarm, as there will be ample time to obtain assistance, which may be delayed for hours without risk under these conditions. Should any portions of the placenta be left behind and infection occur, severe toxremia m.ay develop and prove fatal. If, however, proper precautions have been taken to prevent infection, any portions left behind will be discharged eventually without causing harm. To obviate these effects the uterine cavity should be washed out, either with boiled s.aline solution at a temperature of 112° to 120° F., or a hot, weak solution of an antiseptic. By far the best method of preventing these ill-effects is to avoid introducing tho hand into the uterus, except when covered by a sterilised rubber glove. These rubber gloves should invariably bo worn for all intra-uterine manipulations, and m.ay with great .advan- tage be used in all cases. Lacerated Perineeum—Treatment. In cases of lacerated perinseum. Slight lacera- tions, merely passing through the thin anterior edge of the mucous membrane or fourchette, are common,
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