Aids to obstetrics : double part / by Samuel Nall.

  • Nall, Samuel.
Date:
[1885?]
Catalogue details

Licence: Public Domain Mark

Credit: Aids to obstetrics : double part / by Samuel Nall. Source: Wellcome Collection.

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    remains a little larger than it is in the virgin. During in- volution all the muscular tissue is removed and replaced by newly developed muscle. The Cervix is soft and patulous ; the os externum is torn, and the os internum will admit the finger up to the end of the first week. Like the body, the cervix undergoes involution. Subinvolution is the chronic state of enlargement of the uterus that ensues, when the proper course of involution is interfered with by the patient getting about too early after labour, and other causes. Changes in the Mucous Membrane of the Uterus.—At first the open mouths of the sinuses are seen on the placental site, and the internal surface is covered by the shreddy remains of the decidua. A part of the decidua is cast off in the lochia, but a part remains behind, and by proliferation of the glandular epithelium and interglandular connective tissue a new mucous membrane is formed. Closure of the Uterine Sinuses.—At first they are closed by coagula, which afterwards become organized into connective tissue. Shrinking of this tissue then takes place, and the vessels gradually disappear. The Vagina is smooth and dilated for some days. It quickly undergoes involution, but always remains wider and less rugose than in nulliparae. The Vulva is lax and swollen for a few days. The After Pains are irregular painful contractions of the uterus, which take place during the first four days after labour. They generally depend on the presence of coagula in the uterus, and are relieved by their expulsion. They are most common in multiparse, or when there has been uterine inertia from any cause. When the uterus contracts firmly after birth, as in primiparse, they rarely occur. The Lochia are the discharges from the uterus which persist for about a month after delivery. For the first four days they are red (Lochia rubra or cruenta), and consist of epithelium, decidual debris, blood corpuscles, and often contain blood clots. From the fifth to the ninth day they are greenish and thin (Lochia serosa, or ‘ green waters ’), and contain a few blood and pus