. A system of obstetrics . , to invade the internal genitalia in order to remove -mallshreds of amnion and chorion ; if, however, a great pan of these mem-branes has ben retained, it would seem to the writer advisable to removeit. The diagnosis of retained placenta is, as a rule, easy. When thewhole organ remain- in utero, the cord dangling from the external gen-ital- points clearly enough to the condition. I f one or more cotyledonsremain behind, their absence may be noted from the placenta alter Its 1 Klin. Beitr. tv Qyn&k. u. Qaburts., 1884, 8. 1 16. ? >?>. 3 l.,l,rl»,rh, lOte Autl. 7
. A system of obstetrics . , to invade the internal genitalia in order to remove -mallshreds of amnion and chorion ; if, however, a great pan of these mem-branes has ben retained, it would seem to the writer advisable to removeit. The diagnosis of retained placenta is, as a rule, easy. When thewhole organ remain- in utero, the cord dangling from the external gen-ital- points clearly enough to the condition. I f one or more cotyledonsremain behind, their absence may be noted from the placenta alter Its 1 Klin. Beitr. tv Qyn&k. u. Qaburts., 1884, 8. 1 16. ? >?>. 3 l.,l,rl»,rh, lOte Autl. 707. BerichU a. Studien, 1874 79; Path. *. / <• p. eta W \ : IPath. Therap. dei P on, 1862. 478 COMPLICATIONS OF THE PUERPERAL STATE. delivery. Occasionally, the diagnosis is more difficult, even if thewhole placenta is retained. I recall a ease in which a woman wasdelivered on her feet : the child dropped to the floor, the cord wasdragged off from the foetal surface of the placenta, and the latter Fig. Fibrinous Polyp (Frankel). remained behind in the uterus; it was tightly adherent to the uterinewall, and its discovery, with no cord to guide one, was by no means aneasy matter. It was finally peeled off and extracted, the woman mean-while bleeding furiously. Cotyledons torn off the periphery of the placenta may easily goundetected, and in certain roughly lobulated placenta? it is very PUERPERAL HEMORRHAGE. 479 difficult to be sure that no placental tissue has remained the medical attendant suspects the retention of placental mass safter labor, he must attempt their removal. This is usually not-difficult. The operators hand—the only trustworthy instrumentunder the circumstances—is inserted into the uterine cavity, theplacental substance felt for, caught by the fingers, and removed : ifthe placenta is adherent, the tip of a finger must be gently inserted,wherever most practicable, under the edge, and the whole organ grad-ually peeled off. If the uterine
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectobstetrics, bookyear1
