A nurse's handbook of obstetrics, for use in training-schools . nting delivery. (Garrigues.) Large ovarian cyst, in front ofhead, obstructing the genital canal. The chief indication for Csesarean section is contraction ordeformity of the pelvis which is so marked that it is impossiblefor a viable child to pass through it even with the assistanceof forceps or version, and it may also be rendered necessaryby the presence of abdominal tumors (Fig. 84), cancer of thecervix, overgrowth of the foetus, monstrosity, certain cases of 188 A NURSES HANDBOOK OF OBSTETRICS. twins, and certain malpositions
A nurse's handbook of obstetrics, for use in training-schools . nting delivery. (Garrigues.) Large ovarian cyst, in front ofhead, obstructing the genital canal. The chief indication for Csesarean section is contraction ordeformity of the pelvis which is so marked that it is impossiblefor a viable child to pass through it even with the assistanceof forceps or version, and it may also be rendered necessaryby the presence of abdominal tumors (Fig. 84), cancer of thecervix, overgrowth of the foetus, monstrosity, certain cases of 188 A NURSES HANDBOOK OF OBSTETRICS. twins, and certain malpositions of the fcetus which cannot becorrected. In malignant disease (cancer) of the cervix the uterus andappendages are usually removed at the time of the operation,unless the mother is already in a hopeless condition and thesection is performed solely in the interest of the child. As in any other abdominal operation, the patient lies on herback on a firm table, with a Kelly pad under her buttocks (). All the hair on the abdomen, mons veneris, vulva, and peri-. Fig. 85.—Kelly pad in position under patient, with apron draining into tub or pail. neum is to be carefully shaved off, and the belly, external genitals,and thighs scrubbed and disinfected with the utmost care. Thevagina is also usually made as sterile as possible, but this isgenerally performed by the surgeon or his assistant, and neednot be taken up by the nurse, except under definite case calls for at least two nurses, and four assistants tothe operator. The head nurse has direct charge of the solutions,irrigation, and dressings, and the second nurse makes herselfgenerally useful. The operator stands at the right side of thepatient, facing her head; opposite him is the first assistant,facing the patients feet. Standing on the same side of thepatient as the first assistant, and facing him, is the second assist-ant, whose duty is usually to grasp the blood-vessels at the CESAREAN SECTION. 189 cervix af
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