The principles and practice of obstetrics . take place, the patient becomesalarmed at the delay, and the only consolation she receives is theassurance that it will soon all be right. Another hour elapses, andno expulsion. A consultation is now proposed by the friends—this is of course acceded to, and when the consulting physician * I have already stated that the detachment of the after-birth is frequently com-pleted as soon as the child is expelled through the maternal organs, and this is thecase when the uterus, in response to the exit of the foetus, is found hard and con-tracted in the hypog
The principles and practice of obstetrics . take place, the patient becomesalarmed at the delay, and the only consolation she receives is theassurance that it will soon all be right. Another hour elapses, andno expulsion. A consultation is now proposed by the friends—this is of course acceded to, and when the consulting physician * I have already stated that the detachment of the after-birth is frequently com-pleted as soon as the child is expelled through the maternal organs, and this is thecase when the uterus, in response to the exit of the foetus, is found hard and con-tracted in the hypogastric region; when thus detached from the internal surface ofthe organ, and whether resting over the cervix, or partially in the vagina, therewill be more or less recurrent contraction, simulating the throes of labor, tin- con-traction being induced partly by the presence of the separated after-birth, it beingnow a foreign substance in the uterus, and occasioning irritation of its parietes. THE PRINCIPLES AND PRACTICE OF OBSTETRICS. 61O. arrives, he proceeds like a man who understands his business; lie findsthat the uterus is contracted, introduces his finger into the vagina,feels the detached mass resting over the os uteri, or protruding intothe vagina, and extracts it without delay in the following manner:The end of the cord being enveloped with linen, he makes twoor three twists of it around two of the fingers of one hand, whilehe introduces theindex finger of theother hand (Fig. 58),carrying it up to themouth of the uterus,if the placenta havenot descended intotin- vagina ; this fin-ger then seizes thecord close to the (Fre. 68.) after-birth, and makes traction downward and backward towardthe sacrum in the direction of the superior strait; when the pla-centa has escaped from the womb, the extraction is to be made inthe line of the axis of theinferior strait, always re-membering to withdraw itby rotating it upon itself(Fig. 59), in order that themembranes may be twistedin
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Keywords: ., bookcentury1800, bookdecade1860, bookpubli, booksubjectobstetrics
