Gynaecology for students and practitioners . Fig. 466. Intra-uterine Glass Stems for fse AFTER Dilatation of the Cervix. 796 GYNECOLOGY dysmenorrhoea dilatation should be carried up to number fourteen;when it is desired to pass the finger into the uterus the largest sizesare generally required. When full dilatation of the cervix is required the procedure may berendered easier by the preliminary use of a laminaria tent {see Fig. 467),which should be introduced into the cervix at least twelve hours beforethe operation. The tent swells from imbibition of fluid, and not onlystarts the process of d
Gynaecology for students and practitioners . Fig. 466. Intra-uterine Glass Stems for fse AFTER Dilatation of the Cervix. 796 GYNECOLOGY dysmenorrhoea dilatation should be carried up to number fourteen;when it is desired to pass the finger into the uterus the largest sizesare generally required. When full dilatation of the cervix is required the procedure may berendered easier by the preliminary use of a laminaria tent {see Fig. 467),which should be introduced into the cervix at least twelve hours beforethe operation. The tent swells from imbibition of fluid, and not onlystarts the process of dilatation, but causes so much softening of thecervical tissues that subsequent dilatation with the graduated bougies isfacilitated, and the risk of laceration thus diminished. It is thereforeespecially useful when it is desired to pass the finger into the uterus inthe case of a nuUiparous woman. The disadvantages of the tent are. Fig. 467. a, Laminaria Tent, h, Tent-Forceps. The tent is made ofcompressed sea-tangle, which swells considerably from absorption of moisture. that in an unmarried woman it is difficult to pass it without ananaesthetic, and that while it is in the cervix severe uterine colic(spasmodic contraction) is sometimes set up. Tents may be sterilized by keeping them for a week or ten days inabsolute alcohol. To pass them, a tent-forceps such as is shown inFigure 467 is useful. After preliminary douching of the vagina, thecervix is exposed and seized with a volsella ; the tent is then passed untilthe upper end is well through the internal os. In a nullipara it is bestto pass a small size, and if possible introduce a second beside it. In amultipara a single tent of larger size will suffice. The use of a tent isabsolutely contra-indicated by the presence of purulent or offensivedischarges. A certain amount of preparatory softening of the cervixmay be obtained by the insertion into the vagina of a
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
