. Obstetrics for nurses. of the Umbilical Cord.—Except in emergencies, theumbilical cord should be leftfree until the pulsations in itsvessels have ceased, as experi-ment has shown that duringthis time a portion of the bloodin the vessels of the cord andplacenta gains access to thefetal circulation, so that thechild begins its life with anounce or more blood than itwould otherwise have. Whenthe pulsations can no longerbe detected a few centimetersfrom the childs abdomen(they cease first at the ma-ternal end), the cord is seizedwith two clamps and cut be-tween them. As a permanent
. Obstetrics for nurses. of the Umbilical Cord.—Except in emergencies, theumbilical cord should be leftfree until the pulsations in itsvessels have ceased, as experi-ment has shown that duringthis time a portion of the bloodin the vessels of the cord andplacenta gains access to thefetal circulation, so that thechild begins its life with anounce or more blood than itwould otherwise have. Whenthe pulsations can no longerbe detected a few centimetersfrom the childs abdomen(they cease first at the ma-ternal end), the cord is seizedwith two clamps and cut be-tween them. As a permanentsafeguard against hemorrhage,the cord is now ligated withsterile bobbin an inch or twofrom the childs abdomen, theclamp is removed and the tis-sue cut close to the ligature. Various more or less complicated knotshave been devised for this purpose, but, practically, a snug surgeonsknot is perfectly satisfactory. A sufficiently long stump of cord shouldbe left, so that another ligature may subsequently be applied, should. Fig. 77.—Clearingmouth and throat. mucus from the child)(Berkeley and Bonney.) 142 TEXTBOOK OF OBSTETRICS FOR NURSES bleeding occur as a result of the loosening of the first ligature followingthe shriveling of the cord in the lew hours just after l)irth. The clamp on the maternal end should l)e left in j^lact> ujitil theplacenta has been expelled. Jt serves mainly to prevent soiling of thefield by the blood which may flow from its severed vessels, although theabsence of direct connection between the maternal and fetal circulationsrenders it impossible for the mother to lose any blood, should this pre-caution be omitted. In single ovum twins, however, where the circula-tions anastomose freely, it is conceivable that the unborn twin might))leed to death from the unligated end of the cord of the first child. The dressing for the cord consists of a sterile gauze sponge appliedso as to cover completely its cut end, and retained in position by awide flannel bin
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