The practice of obstetrics, designed for the use of students and practitioners of medicine . o be a real obstruction from traumatismof the urinary apparatus, especially the urethra. Before resorting to the use of thecatheter, which is always attended with some risk of bladder infection, all otherknown means for relieving the condition should be tried, as the sound of runningwater, allowing a stream of warm water to flow over the vulva into a douche pan,the application of hot chloroform stupes to the vulva, and, if not contraindicated,allowing the patient to assume the sitting posture in bed on
The practice of obstetrics, designed for the use of students and practitioners of medicine . o be a real obstruction from traumatismof the urinary apparatus, especially the urethra. Before resorting to the use of thecatheter, which is always attended with some risk of bladder infection, all otherknown means for relieving the condition should be tried, as the sound of runningwater, allowing a stream of warm water to flow over the vulva into a douche pan,the application of hot chloroform stupes to the vulva, and, if not contraindicated,allowing the patient to assume the sitting posture in bed on the vessel or douchepan. If this last procedure is permitted in the first twenty-four hours of thepuerperium, the nurse should be instructed carefully to watch the fundus uteriduring the evacuation of the bladder. Whatever the cause, a period not longerthan eighteen hours should be allowed to pass before the patient is catheterized,and in this operation all possible antiseptic precautions should be taken. Reten-tion is most common after suture of the perineum. The bladder may be injured. Fig. 927.—Retention of Urine and Distended Blad-der DURING THE EaRLY PaRT OF THE PuERPERIUM. URINARY ANOMALIES. 707 by retention and uterine hemorrhage occur from the excessive distention ofthe organ. (See Puerperal Hemorrhage, page 701.) (Fig. 927.) 4. Cystitis.—This is unfortunately quite common in the puerperium and isa serious affection of the urinary system to be guarded against, since it maylead to a fatal result. Frequently it does not pass beyond the mild form,and its duration is then only transitory. Etiology: The common cause iscareless introduction of the catheter. This should always be done underthe strictest antiseptic precautions. The urethral orifice should never besliielded by the bed-sheet, but ought in all cases to be perfectly exposed tothe view of the operator. Again, though rarely, overdistention of the bladderor pressure of the childs head may injure the vesical walls
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
