A manual of obstetric practice : for students and practitioners / by A. Dührssen ; translated and edited from the 6th amended and enlarged ed., by John W. Taylor and Frederick Edge.

  • Dührssen, Jacob Alfred, 1862-1933.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: A manual of obstetric practice : for students and practitioners / by A. Dührssen ; translated and edited from the 6th amended and enlarged ed., by John W. Taylor and Frederick Edge. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    advised simple wool tamponade in both cases, but agrees that Porro's operation is indicated in very rare cases since he himself has operated with success under these con- ditions). The symptoms are those of internal bleeding. Without any visible reason, or after only slight trauma, symptoms of severe collapse, pallor, ptilselessness, gaping, dyspnoea, and vomiting come on. W^ith these there is severe ab dominal pain and generally a sensation of bursting, the uterus is tense, distended, and very tender, the parts of the child are scarcely if at all perceptible, the pains cease. If these signs come on delivery should be proceeded with by the aid of deep incisions in primiparae and with me- chanical dilatation in multiparee, followed by combined version and slow extraction. If delivery is impossible, ergot, friction of the uterus, hot douching, and rupture of the membranes are used. As the prognosis is very unfavourable because rapid de- livery per vias naturales is often impossible, such cases, if in a hospital, may be submitted to Csesarean section, as first recommended by the author and accepted by Kaltenbach. Or the author's vaginal Cresarean section may be pei'formed. If the external bleeding is due to delay in rupture of the membranes and haemorrhage con- tinues after full dilatation of the cervix, the membranes should be ruptured. Further separation of the placenta then ceases; the bleeding is never greater, but stops as a result of the retraction of the uterus after the membranes are ruptured. If the OS uteri is imperfectly dilated, and the mem- branes remain unruptured, vaginal tamponading is per- formed for external hsemorrhage, but any signs of internal bleeding should be watched for; this demands immediate removal of the tampon.