The interpretation of the Porro uterus in relation to the third stage of labour / by D. Berry Hart.

  • Hart, D. Berry (David Berry), 1851-1920.
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Licence: Public Domain Mark

Credit: The interpretation of the Porro uterus in relation to the third stage of labour / by D. Berry Hart. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    The faults of this method are— 1. The placenta is separated, or an attempt is made to separate it, during the pains—the wrong mechanism of separation, I hold. 2. The uterus does not get the necessary rest between its contractions, and thus inertia is brought on. 3. When partially separated, the expression may tear off the bulk of the placenta or membranes from an unseparated portion. The second method is to keep the hand permanently on the uterus, wait for pains, and not to compress the uterus unless there are indications for it, the main one being hsemorrhage. The size of the uterus should be noted, and only when its bulk markedly diminishes, indicating separation, should gentle expres- sion of the uterus or pressure in the supra-pubic region, according as the placenta is in the lower uterine segment or in the vagina, be employed. This method goes on the theory that the placenta is separated after the pain, that hand pressure will not separate it safely at the time, and that the safe time to use hand grasping is after the placenta has separated. The time for the Third stage varies from twenty minutes to an hour, and the practitioner who gives the proper time and follows this plan with the necessary patience Nature demands, will have the reward she always gives to those who understand and obey her. Literature. Barbour, A. H. Freeland, Edin. Ohst. Trans., vol. ix. Duncan, J. Matthews, Mech. of Nat. and Morbid Parturition, Edin., A. & C. Black, 1875. Hart, D. Berry, Edin. Obst. Trans., vol. xii. ; Proc. of Royal Soc. of Edin., vol. XV. ; and Re2)ort of Laboratory of Royal College of Phxjsicians, Edin., vol. i. 1889. Meyer, Moraller and Hoelil, Atlas der normalen Histologie der weiblichen Geschlechtsorgane, Leipzig, Barth, 1909. This gives excellent micro-photo- graphs showing the distribution of the elastic tissue in the female genital tract.