The principles and practice of obstetrics . xtract it. With this view, the hand is to be cautiously intro-duced in a conoid form into the uterus, and following the cord asa guide, it will soon reach the placenta; the other hand should beplaced upon the abdomen over the site of the placenta, for the pur-pose of steadying the uterus. This body will be either in completeadhesion with the womb, or will only be partially so. In the lattercase, the fingers should be insinuated,?with the dorsal surface toward the uterus,between the latter organ and placenta,commencing at the point of h
The principles and practice of obstetrics . xtract it. With this view, the hand is to be cautiously intro-duced in a conoid form into the uterus, and following the cord asa guide, it will soon reach the placenta; the other hand should beplaced upon the abdomen over the site of the placenta, for the pur-pose of steadying the uterus. This body will be either in completeadhesion with the womb, or will only be partially so. In the lattercase, the fingers should be insinuated,?with the dorsal surface toward the uterus,between the latter organ and placenta,commencing at the point of hand is then made to glide betweenthese two surfaces (Fig. 62), and bygentle manipulation, the detachment maybe accomplished. After the placenta hasbeen separated, it should be withdrawnaccording to the directions to which wehave already alluded. Should it, how-ever, occur that the hand cannot detach the body, then it should be brought away in fragments, and at thesame time every reasonable attempt made to extract the whole ofthe mass. 25. 386 THE PRINCIPLES AND PRACTICE OF OBSTETRICS. When there is complete adhesion, the safer practice, in myopinion, is to introduce the hand, and Btretching the Bngera oveithe foetal surface of the placenta, as far as the peripheral edge,gentle traction should be made upon this edge by drawing the fingers toward the palm of the hand; this somewhat simulates themode in which the uterus, under the influence of contraction, proceeds iu the separation. The plan just suggested is far preferable to that recommended bysome authors, viz., to make tractions upon the cord with the hopethat these tractions will result in the detachment of the danger of this practice must be quite evident to you, consistingin liability to rupture of the cord, inversion of the uterus, etc. Forthese reasons, it should not be resorted to, and I trust you will notforget this admonition. It willoccasionally, however, happen that, notwithstanding the best-directed
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