On acute inversion of the uterus / by Thomas More Madden.

Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: On acute inversion of the uterus / by Thomas More Madden. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    4/12 (page 4)
    residence I found Dr. Torney in attendance, and the patient in a state of collapse, pulseless, icy cold, blanched, respiration sighing, and exhibiting all the symptoms which generally attend cases of great hemorrhage. That this had taken place before my arrival, was evinced by the saturated condition of her bed, although the midwife denied that such had been the case. On examination I found the uterus completely inverted, protrud- ing between her legs, with the placenta firmly adherent to the fundus, from which a considerable draining of blood was still going on. The history of the case was that the patient, M. L., aged eighteen, had been delivered of a living child, at full time, at a quarter past four, p.m. She had had a very quick and easy labour, which com- menced at eleven, a.m., that morning, although the membranes were ruptured immediately before the first true pain occurred. It was her third pregnancy, as she had been married when only fourteen and a half years old. After the birth of the child the midwife who attended her, as, unfortunately as it turned out, no accoucheur was engaged, informed me that there was considerable hemorrhage during the third stage. The placenta being retained she endea- voured to press it off, but not succeeding in effecting this, she sent for Dr. Swan, of Steevens’s Hospital, but as he was out at the time, she stated that she introduced two fingers into the os to ascertain if the placenta was adherent or not, directing another woman in the meanwhile to make firm pressure over the fundus uteri. She denied pulling the funis, or even leaving it on the stretch at this moment, when suddenly, as she alleged, from the pressure of the woman who was pressing down the fundus, the womb became completely inverted and was extruded from the vulva. She now sent for Dr. Torney, who came at once, and on his arrival, finding the woman pulseless and moribund, and considering the serious nature of the case, sent up to the hospital for assistance, and in the meantime very judiciously administered stimulants, and applied a sinapism over the heart. When I arrived, the woman was in the condition just described, and accordingly, having first administered as large a quantity of brandy and ammonia as I could get her to swallow, I at once pro- ceeded to peel off the placenta which was morbidly adherent to a great part of the fundus. She was lying in a pool of blood when I examined her, and the hemorrhage was going on to a considerable extent before and during the operation, but was not at all increased