. An American text-book of obstetrics. For practitioners and students. may be the result of kidney insufficiency or of pressurein a prolonged labor. The increased bulk of the dropsical labia may interferewith the escape of the presenting part, or, what is more likely, the edematoustissues lose their elasticity, obstruct labor by their rigidity, and are prone to deeptears at the time of birth and to gangrene afterward. Punctures or incisions inthe labia may be necessary to escape more serious injury, but it is well to avoidthem if possible, for they are apt to be followed by infection and gangr
. An American text-book of obstetrics. For practitioners and students. may be the result of kidney insufficiency or of pressurein a prolonged labor. The increased bulk of the dropsical labia may interferewith the escape of the presenting part, or, what is more likely, the edematoustissues lose their elasticity, obstruct labor by their rigidity, and are prone to deeptears at the time of birth and to gangrene afterward. Punctures or incisions inthe labia may be necessary to escape more serious injury, but it is well to avoidthem if possible, for they are apt to be followed by infection and gangrene. DYSTOCIA. 551 An abscess of Bartholins gland is seldom large enough to retard labor,though it has done so (Midler), but it is likely to cause trouble should be opened freely in the early part of the first stage of labor,curetted, swabbed out with carbolic acid and glycerin, and packed with iodo-form gauze. Gangrene of the vulva is very rare before the termination of it exist, it might determine an operator in favor of Cesarean section. Fig. 347.—Edema and beginning gangrene of the vulva from prolonged pressure in an obstructed labor (Hirst). in a doubtful case, on account of the rigidity of the vulvar tissues, the cer-tainty of laceration, and the likelihood of grave infection. Enlarged Caruncuke Murtiformes and Varicose Veins.—These tumors donot possess sufficient bulk, as a rule, seriously to obstruct the last stage oflabor. They may, however, be so bruisedby the passage of the head as to slough after-ward, or the veins in them may be ruptured,giving rise to subcutaneous or frank bleed-ing of an alarming character. Vaginismus may be overcome by an anes-thetic. Congenital narrowness of the vaginaand vulva is usually overcome by the ad-vance of the presenting part, though often atthe expense of vaginal and perineal lacera-tions. It may be necessary to resort tohydrostatic dilatation, or even, in rare in-stances, to Diihrssens plan of multiple
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
