A treatise on the science and practice of midwifery . detected before the fulldilatation of the cervix, and when the membranes are unruptured, 322 LABOR. we must try to keep the cord out of the way; to preserve the mem-branes intact as long as possible, since the cord is tolerably protectedas long as it is surrounded by the liquor amnii; and to secure thecomplete dilatation of the os, so that the presenting part may engagerapidly and completely. Postural Treatment.—Much may be done at this time by the pos-tural treatment, which we chiefly owe to the ingenuity of Dr. Gail-lard Thomas, of New Yo
A treatise on the science and practice of midwifery . detected before the fulldilatation of the cervix, and when the membranes are unruptured, 322 LABOR. we must try to keep the cord out of the way; to preserve the mem-branes intact as long as possible, since the cord is tolerably protectedas long as it is surrounded by the liquor amnii; and to secure thecomplete dilatation of the os, so that the presenting part may engagerapidly and completely. Postural Treatment.—Much may be done at this time by the pos-tural treatment, which we chiefly owe to the ingenuity of Dr. Gail-lard Thomas, of New York, whose writings familiarized the professionwith it, although it appears that a somewhat similar plan had beenoccasionally adopted previously. Dr. Thomass method is based onthe principle of causing the cord to slip back into the uterine cavityby its own weight. For this purpose the patient is placed on herhands and knees, with the hips elevated, and the shoulders restingon a lower level (Fig. 118). The cervix is then no longer the most Fig. Postural Treatment of Prolapse of the Cord. dependent portion of the uterus, and the anterior wall of the uterusforms an inclined plane down which the cord slips. The success ofthis manoeuvre is sometimes very great, but by no means always is most likely to succeed when the membranes are , when adopted, the cord slip away, and the os be sufficiently dilated,the membranes may be ruptured, and engagement of the head pro-duced by properly applied uterine pressure. Sometimes the positionis so irksome that it is impossible to resort to it. Postural treatmentis not even then altogether impossible, for by placing the patient onthe side opposite to that of the prolapse, so as to relieve the cord asmuch as possible from pressure, and at the same time elevating thehips by a pillow, it may slip back. Even after the membranes areruptured, postural treatment in one form or another may succeed ;and, as it is simple and harmles
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Keywords: ., bookcentury1800, bookdecade1870, bookidtre, booksubjectobstetrics
