Atlas and epitome of labor and operative obstetrics / by Oskar Schaeffer ; edited by J. Clifton Edgar.

  • Schäffer, Oskar.
Date:
1901
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Licence: In copyright

Credit: Atlas and epitome of labor and operative obstetrics / by Oskar Schaeffer ; edited by J. Clifton Edgar. Source: Wellcome Collection.

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    developed, Porro’s supravaginal amputatiou must be {>tr- formed. In all other cases, especially in private praetice, extrac- tion per- vias naturales and tamj)onade of tlie laceration and of tlie uterine cavity shoidd l)e performed. If tlie hemorrhage cannot be controlled, the cervix is liberated by incisiuns, Douglas’ poucli is opened, the main arteries are clainped or ligated, and a ganze tampon is inserted. (c) In tumors (comj)are Atlas of Obstetr-ic Diagnosis and Treatment, setiond edition, § 21 d to /). § 34. Symphysiotomy (Morisani): Necessary Conditions.—1. The child must be living and viable (heart-sounds good). 2. The mother mu.st be vigorous (no infection). 3. The pelvis must not be an- kylosed nor obliquely contracted, nor heart- or kidney- shaped. 4. The soft parts of the parturient canal must be sufficiently dilated. This condition applies only rela- tivcly to primiparse. Indications.—Contracted pelves with conjugata vera 2|-3 in. (6-7.5 cm.). 2. Presentation of the po.^terior j)arietal bone and unfavorable pelvic conditions. 3. Face presentations, chin postei’ior. 4. Abnormally large child, even when the pelvis is normal. 5. Eclampsia when the fetal head is large. 6. Impendiug rupture of the uterus. In general, it may be said that symphysiotomy is per- formed instead of Perforation or when there is a relative indication for Cesarean section—that is, in cases in which prematnre labor should have been induced after the thirty- third weck ; but whenever the condition is properly recog- nized at the right time, prematnre labor should be induced. In private praetice, symphysiotomy is rarely resorted to; hence first pregnancies, infection, and prematnre ru]>- ture of the membranes constitute a eontraindication much oftener than in hospital praetice (Leopold). Rupture of the membranes is to be avoided if po.ssible, and, if it occurs, their function must be replaced by the application of the colpeurynter and injections of mucoid material. Later the vagina and perineum must be incised.