Obstetric operations

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D. Appleton & Company, 1870 - 483 pages
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Page 379 - Pass one or two fingers as far as they will go through the os uteri, the hand being passed into the vagina if necessary ; feeling the placenta, insinuate the finger between it and the uterine wall ; sweep the finger round in a circle so as to separate the placenta as far as the finger can reach...
Page 407 - ... in utero; if on pulling on the cord, two fingers being pressed into the placenta at the root, you feel the placenta and uterus descend in one mass, a sense of dragging pain being elicited; if, during a pain the uterine tumor does not present a globular form, but be more prominent than usual at the place of placental attachment."* Treatment of Adherent Placenta.
Page 273 - Instantly, the wire is buried in the scalp ; and here is manifested a singular advantage of this operation. The whole force of the necessary manoeuvres is expended on the foetus. In the ordinary modes of performing embryotomy, as by the crotchet especially, and in a lesser degree by the craniotomy-forceps and cephalotribe, the mother's soft parts are subjected to pressure and contusion.
Page 409 - I have opened more than one body where a part of the placenta was left adherent to the uterus, and where, on making a longitudinal section of the organs and examining the cut edges, I could not determine the boundary line between them.
Page 385 - Since a cross-presentation or other unfavorable position of the child is apt to impede or destroy the regular contractions of the uterus, which are necessary to arrest the flooding, it is mostly desirable to deliver as soon as the condition of the os uteri will permit. 6. In some cases the simple use of means to excite contraction of the uterus, as rupturing the membranes or the employment of galvanism, may suffice to arrest the hemorrhage.
Page 29 - ... perforate, to destroy -the child. Such an alternative may well make us reflect whether we cannot extend the powers and the application of the forceps. By simply lengthening the blades and shanks and giving the blades an additional curve adapted to the curved sacrum, we can reach the head detained at the brim of the pelvis. By moderately lengthening the handles and making the instrument stronger, we increase the leverage and tractile power, and we gain a moderate compressive power. Thus we bring...
Page 327 - ... it is estimated, or, as is far better, where it is proved that a child at full term cannot be delivered except by instrumental or manual means, premature delivery is called for. Still speaking generally, the normal length of the shortest diameter of the pelvis is 4 inches ; between this and 3 inches is the domain of the forceps ; between 3 inches and 2, that of version ; between 2 and 2, that of craniotomy ; and under 2 inches, that of the caesarean section.
Page 277 - Csesarean section occupies a doubtful place between conservative and sacrificial midwifery. It is conservative in its design, in its ambition; it is too often sacrificial in fact. It is resorted to with a feeling akin to despair for the fate of the mother, which is scarcely tempered by the hope of rescuing the child.
Page 366 - All placenta fixed here, whether it consist in a flap encroaching downwards from the meridional zone, or whether it be the entire placenta, is liable to previous detachment. The mouth of the womb must be pulled open to give passage to the head. This enormous contraction or re-traction of the longitudinal cervical fibres is incompatible with the preservation of the adhesion of the placenta which is within its scope.
Page 274 - When the anterior or posterior segment of the head is seized in the wire loop, a steady working of the screw cuts through the head in a few minutes. The loose segment is then removed by the craniotomy forceps. In minor degrees of contraction, the removal of one segment is enough to enable the rest of the head to be extracted by the craniotomy forceps. But in the class of extreme cases, in which this operation is especially useful, it is desirable still further to reduce the head, by taking off another...

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