Selected obstetrical and gynecological works / or Sir James Simpson ; containing the substance of his lectures on midwifery ; edited by J. Watt Black.

  • Simpson, James Young, 1811-1870.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: Selected obstetrical and gynecological works / or Sir James Simpson ; containing the substance of his lectures on midwifery ; edited by J. Watt Black. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    General Rides for the Management of the Third Stage. 1. Wait for ten or twenty minutes to see if expulsive pains recur to expel the placenta. 2. Then ascertain if the placenta is in the uterus or in the vagina, by external and internal examination. If you touch the foetal surface by tracing the cord to its root, it is in the vagina. 3. If the placenta be already in the vagina, extract it. 4. If the placenta be still in the uterus, re-excite uterine contractions by friction, cold or warmth, slight traction at the cord, but, above all, by compression of the uterus. 5. When these means are insufficient, at the end of an hour pass your hand into the uterus and extract the placenta. 6. Make all tractions on the cord, and always extract the placenta itself, in the line of the different pelvic axes. 7. Take especial care to bring away both the placenta and membranes entire. (If there be hemorrhage you must extract the placenta, or expel it by compression of the uterus, immediately.) Subsequent Duties of the Medical Attendant in reference to the Mother. 1. Apply immediately a warm cloth to the pudenda. 2. Place a binder upon the abdomen and pelvis. (Use but do not abuse the binder.) 3. Eemain with the patient for at least an hour. 4. Before leaving her, ascertain— (1.) If the uterus is contracted. (2.) If the discharge is not too profuse. (3.) If there are no marked constitutional symptoms, and if the circulation is neither morbidly depressed nor excited. 5. Guard against the patient leaving the horizontal position, or being exposed to any exciting mental or bodily stimuli. 6. Leave injunctions to be called if faintness, rigors, or con- tinued pelvic pain supervene.