A textbook of obstetrics . Fig. 261.—The expulsion of the placenta inverted (Varnier). in 312 cases. The adhesion is rarely complete ; a part of theplacenta is usually detached. This condition of affairs neces-sarily gives rise to profuse hemorrhage. The placental sinusesare torn when the placenta is detached, but the womb can not THE MECHANISM OF LABOR. contract and close them, because of the attached area and inconsequence of the retention of the whole placental mass withinthe uterus (see Fig. 262). Diagnosis.—Credes method of expression fails completely toexpress the placenta ; the womb wil
A textbook of obstetrics . Fig. 261.—The expulsion of the placenta inverted (Varnier). in 312 cases. The adhesion is rarely complete ; a part of theplacenta is usually detached. This condition of affairs neces-sarily gives rise to profuse hemorrhage. The placental sinusesare torn when the placenta is detached, but the womb can not THE MECHANISM OF LABOR. contract and close them, because of the attached area and inconsequence of the retention of the whole placental mass withinthe uterus (see Fig. 262). Diagnosis.—Credes method of expression fails completely toexpress the placenta ; the womb will not firmly contract, andthere is alarming hemorrhage. Treatment.— The hand should be inserted alone the cord as «. Fig. 262.—Partial detachment f the placenta. Vertical mesial section from a ( ase of eclampsia, delivered in articulo mortis by forceps: </, Placenta still attached ; /-. placenta separated from its site and hanging free; c, membranes; </, blood;. membranes (Strata). a guide to the placenta. A detached edge should be sought,under which the fingers are inserted, and the separation is com-pleted with the finger-tips, moving them from side to side. Oc-casionally it will be necessary to pinch through a dense spot ofadhesion with the nails ! the thumb and forefinger. The pla-centa being separated, the- fingers should be closed about it. MECHANISM 01 THE THIRD STAGE 01 LABOR. 399 The fundus should be stimulated by friction through the abdom-inal wall, and the uterine contractions should be allowed toexpel the hand and the contained placenta. It is unwise to pullthe plaeenta out, even when it is eompletely detached, lor thecombined mass of the plaeenta and hand may ac
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
