Lectures on obstetric operations : including the treatment of haemorrhage, and forming a guide to the management of difficult labour / by Robert Barnes.

Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on obstetric operations : including the treatment of haemorrhage, and forming a guide to the management of difficult labour / by Robert Barnes. 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.

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    also, in eveiy case, examine per vaginam, to ascertain if there is anything in the uterus. The first question of a practical nature is, Can the abortion he averted ? Can gestation continue ? If you have found any portion of the embryo or membranes in the matters expelled, you must give up the hope of this. If you find very active expulsive pains, attended with free hsemorrhage, affecting the patient's strength, and if the os uteri is opening so as to admit the finger freely, you may, even if no portion of the ovum has been expelled, give up the hope of averting abortion. The sooner the ovum, or the remains of it, are voided, the sooner the patient will be out of danger. This, then, is the first indication : Empty the uterus. How ? Sometimes you will feel the ovum projecting partly through the os. It feels like a polypus. In this case it is jDrobably detached, and under j^roper manipulation it will come away. The method of proceeding is as follows:—The patient laying on her back or on her side, with the thighs flexed so as to relax the abdominal walls, you press with the palm of one hand above the symphysis upon the fundus of the uterus, so as to depress the organ well into the pelvic cavity. By this manoeuvre you carry the os lower down, making it more accessible to the finger passed internally, and you support the organ by providing counter pressure. This singularly facHitates the penetration of the cavity by the finger, which must generally pass to the fundus, in order to get hold of the ovum and scoop it out. Generally the uterus, in abortion, is low in the