Case of spontaneous expulsion of child : with remarks / by Robert Dyce.

  • Dyce, Robert, 1798-1869.
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: Case of spontaneous expulsion of child : with remarks / by Robert Dyce. Source: Wellcome Collection.

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    much as can be effected by gentle means, leaving the remainder to be thrown off in the discharges. In this we concur.”—And in the detail of cases under the head of u Retained Placenta,” Nos. 60 and I 100, are practical illustrations of the rule. He took away as much as he could, cautiously, and left the rest adhering, from an unwilling- [ ness to use violence. Both patients were discharged on the tenth i and eighteenth day respectively. Burns is no less explicit; he says :—u If the adhesion of any part j of the placenta be very intimate, we must not, in order to destroy it, ;; scrape and irritate the surface of the uterus, but ought rather to i: remove all that does not adhere intimately, leaving the rest to be | separated by nature.” Here, then, are evidences of the safety of the practice, where no bad results followed, and yet where no vestige of the retained por- i tion has ever appeared. But there are still more remarkable cases, where not only a portion, but the whole placenta, has been retained, i and perfect recovery followed. The late Dr Young details a case of this description, which is thus related in a manuscript copy of his lec¬ tures which I possess :—u The woman had been two hours brought to bed, and all the different methods had been made use of to extract the placenta. The cord was broke. I put the woman on her side, ; and introduced my hand, but could not get hold of the placenta. I could get my hand up to it, but no further, the uterus having formed a sort of pouch for it; so that at last I was obliged to trust the matter entirely to nature, and, what was very uncommon, no fetid stuff came aivay, nor anything like the placenta, and yet the woman recovered, and continued in good health.” He also notices, what must have occurred to others, as it has to myself, that fre¬ quently in cases of abortion, where the embryo has escaped, no mem¬ branes or placenta ever appeared, and, in fact, where no trace of these was ever afterwards seen—yet no bad consequences followed. The catamenia in due time returned, and the females became preg¬ nant as usual. There are also cases reported where the placenta has been retained for many days in the uterus, and then expelled with little signs of putrefaction. Denman mentions one which did not pass off for fifteen days, and without any ill consequences. I might bring forward other cases of a similar nature; but these may be sufficient to show, that a large portion of placenta may be left behind with perfect safety. This being the case, it is, in my opinion, attended with much less risk to the mother, in cases of morbidlv * «/ adhering placenta, to leave the portion attached, rather than, by striving to bring it away, to risk the infliction of a positive injury upon the uterus, which will almost certainly terminate in death. MURRAY AND GIBB, PRINTERS, EDINBURGH. /