Observations on the Caesarean section and on other obstetric operations : with an appendix of cases / by Thomas Radford.

Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the Caesarean section and on other obstetric operations : with an appendix of cases / by Thomas Radford. 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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    Long and ineffectual attempts to deliver by the perforator and crotchet are highly dangerous. Contusion, laceratious, inflamma- tion, Infiltration, suppuration, and sloughing, are consequences which are not unusually to be found in cases in whicli violent efforts have been made to drag a mangled infant through a contracted pelvis. II.—On the Causes of Infantile Mortality. The foetus in utero sometimes dies from diseases which occur in its own system, and also from morbid changes in the structm-e of the placenta, which Interrupts the supply of blood from this organ. These causes are not, however, confined in their Operation to any particular class of cases. The duration of labour exercises very great influence upon the infant. If the membranes remain entire, and the liquor amnii undischarged, it will endure the continuance and violence of the labour-pains for a considerable length of time without injury. But after this event has happened, there is much more risk of mischief ; and the danger increases in a ratio proportioned to the length of time the labour is protracted. The deaths of the infauts which have occurred in Csesarean cases are generally to be attributed to the long continued and violent pressure which they have endured during labour. There is, however, another cause of infantile death which more especially belongs to the Cfesarean section. I mean the spasmodic seizure of the neck or body of the infant during its extraction through the incised opening of the uterus. In general, there is no difficulty experienced in these cases in -withdrawing the infant from the uterus ; but sometimes some portion of its body becomes so firmly grasped by the uterus in its passage through the incised opening that great difficulty is experienced in extracting it. There is, however, more danger to the infant when the neck is seized by the uterine grasp than when it is held by any other part of its body. In such cases the body of the infant has been most easily brought along until the Shoulder had passed, when the neck is instantaneously seized, and so firmly held, as to require long and continued efforts to be made in order to extricate the head. The fact, that the uterus in natural labour is energctically roused to expel the placenta which has been separated, first led me to attri- bute the seizure of the neck of the chiid during the CsEsarean section to the partial or complete detachment of the placenta. It has lately been doubted whether this theory will suffice to explain it, as numer- ous instances are recorded in which the placenta either protruded ]>
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