Difficult labour : a guide to its management for students and practitioners / by G. Ernest Herman.

  • Herman, G. Ernest (George Ernest), 1849-1914.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Difficult labour : a guide to its management for students and practitioners / by G. Ernest Herman. 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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    C. Vaginal examination. Presenting part can be pushed Presenting part cannot be up easily. pushed up. Caput succedaneum small, so If head in pelvic cavity, great that sutures can be felt. caput succedaneum, so that . sutures cannot be felt. Little or no swelling of vagina If head in cavity vagina and and vulva. vulva swollen. Remember also the contrast in D. Treatment. Give the patient sleep : do not Deliver without delay, deliver her. In tonic contraction of the uterus ergot ought never to he given, because its effect is to cause this condition and increase it when present. Prevention.—You ought never to allow the uterus to get into a state of tonic contraction. The conditions which lead to insuperable obstruction ought to be found out quite early in labour: for they are easy to ascertain. Contraction of the pelvis, great enough to prevent the delivery of a living child, ought to be noticed when you make your first examination, and if suspected, the pelvis should be measured. A transverse position of the child ought to be found out and corrected early in labour. If the child, or part of it, be so large with relation to the pelvis that it cannot enter it, this ought to be ascertained early in the labour: and if it be certain that the child cannot pass through the pelvis, the alternatives of embryotomy or CiEsarian section should be put before the patient : and the mode of delivery, upon which she, with the help of your advice, decides, should be carried out without delay. Premature uterine retraction. — The three above described are the common varieties of lingering labour. There is another kind, first described by Litz- mann,* and brought before English readers by Mat- thews Duncan.t This condition is rare. I have seen one case. It occurs chiefly in young primiparso, of • Arch, fikr Gyn., Band x. t Obst. Jouimal, vol. v.