The principles and practice of obstetrics . le thebladder, compressed between the abdominal nand uterus, will be greatly irritated, and has, infew instances, been ruptured, with, of course, fatalresults. In some rare cases, the bladder is pushed, before orduring labor, underneath the uterus, and when dis-tended forms a large swelling, occupying the cavityof the pelvis, and obstructing the vagina. In acase of labor, to which the author was called duringthe second stage, he found a large, fluctuating, softtumor, pressing down toward the vulva; while thefinger could, with difficulty, be passed un
The principles and practice of obstetrics . le thebladder, compressed between the abdominal nand uterus, will be greatly irritated, and has, infew instances, been ruptured, with, of course, fatalresults. In some rare cases, the bladder is pushed, before orduring labor, underneath the uterus, and when dis-tended forms a large swelling, occupying the cavityof the pelvis, and obstructing the vagina. In acase of labor, to which the author was called duringthe second stage, he found a large, fluctuating, softtumor, pressing down toward the vulva; while thefinger could, with difficulty, be passed under it to reachthe os uteri, which last was found nearly dilated. Thepatient had suffered exceedingly from this complication,especially as the bearing-down efforts were Ramsbotham gives an account of a similar case,with an illustration, a copy of which we present. When the anterior wall of the vagina is much re-laxed or elongated, this cystic tumor may descend tothe vulva, and sometimes protrude externally, consti- Fi<*. Dystocia from Displacement of the Bladder.—A. The Distended Bladder. tuting what has been termed a cystic hernia,This would aggravate the sufferings and the dangersof the patient. The diagnosis is not difficult to the thoughtful andprudent accoucheur; but nevertheless, such swellingshave been mistaken, says Merriman, for a hydro- TUMORS. 513 cephalic head, and also, as reported by Hamilton, forthe membranes of the ovum; in both of which casesthe bladder was punctured. It might also be mistakenfor an ovarian dropsy, or for other encysted tumors ofthe pelvis. Hence, great caution should always beexercised, and no operation be performed until a cathe-ter had been previously introduced into the urine being evacuated, the cystic tumor will col-lapse, and all doubt of its character be dissipated. The management of a labor with a misplaced blad-der should be, therefore, carefully conducted. Thepatient should suspend all bearing-down e
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Keywords: ., boo, bookcentury1800, booksubjectobstetrics, booksubjectpregnancy
