A treatise on the science and practice of midwifery . the vulva. Treatment.—In the treatment the great indication is to prevent thecord from being unduly pressed on, and all our endeavors must havethis object in view. If the presentation be detected before the full dila-tation of the cervix and when the membranes are unruptured, we musttry to keep the cord out of the way; to preserve the membranes intactas long as possible, since the cord is tolerably protected as long as it issurrounded by the liquor amnii; and to secure the complete dilatationof the os, so that the presenting part may engage
A treatise on the science and practice of midwifery . the vulva. Treatment.—In the treatment the great indication is to prevent thecord from being unduly pressed on, and all our endeavors must havethis object in view. If the presentation be detected before the full dila-tation of the cervix and when the membranes are unruptured, we musttry to keep the cord out of the way; to preserve the membranes intactas long as possible, since the cord is tolerably protected as long as it issurrounded by the liquor amnii; and to secure the complete dilatationof the os, so that the presenting part may engage rapidly and completely. Postural Treatment.—Much may be done at this time by the posturaltreatment, which we chiefly owe to the ingenuity of Dr. T. GaillardThomas of New York, whose writings familiarized the profession withit, although it appears that a somewhat similar plan had been occasion-ally adopted previously. Dr. Thomass method is based on the principleof causing the cord to slip back into the uterine cavity by its own weight. Fig. Postural Treatment of Prolapse of the Cord. For this purpose the patient is placed on her hands and knees, with thehips elevated and the shoulders resting on a lower level (Fig. 122). Thecervix is then no longer the most dependent portion of the uterus, andthe anterior wall of the uterus forms an inclined plane down which the PRESENTATIONS OF SHOULDER, ETC. 335 cord slips. The success of this manoeuvre is sometimes very great, butby no means always so. It is most likely to succeed when the mem-branes are unruptured. If, when adopted, the cord slip away and theos be sufficiently dilated, the membranes may be ruptured, and engage-ment of the head produced by properly-applied uterine pressure. Some-times the position is so irksome that it is impossible to resort to treatment is not even then altogether impossible, for by placingthe patient on the side opposite to that of the prolapse, so as to relievethe cord as much as po
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectobstetrics, bookyear1
