The practice of obstetrics, designed for the use of students and practitioners of medicine . stage. The perineumand vagina should be carefully examined, as manysevere lacerations are not visible externally. Thelabia are separated by the fingers wrapped in ster-ile gauze or cotton, both hands being used, andthe parts thoroughly inspected. Here as else-where, however, intra-rectal manipulations are tobe avoided if possible. The occurrence of ratherfree hemorrhage during the latter part of thesecond stage may indicate a vaginal Vulval Dressing (Fig. 633).—Immediately after
The practice of obstetrics, designed for the use of students and practitioners of medicine . stage. The perineumand vagina should be carefully examined, as manysevere lacerations are not visible externally. Thelabia are separated by the fingers wrapped in ster-ile gauze or cotton, both hands being used, andthe parts thoroughly inspected. Here as else-where, however, intra-rectal manipulations are tobe avoided if possible. The occurrence of ratherfree hemorrhage during the latter part of thesecond stage may indicate a vaginal Vulval Dressing (Fig. 633).—Immediately after the expulsionof the child, I am accustomed to place over the gaping vulva an antisepticdressing, either several folds of aseptic gauze or one of the aseptic vulval pads incommon use. This dressing is allowed to remain in situ until the placentadisplaces it on the delivery of the latter. This dressing I use with two objectsin view: first, to prevent, as far as possible, the entrance of air into the gap-ing vagina; and, second, to indicate the amount of hemorrhage going on atthis Fig. 633.—Temporary VulvalDressing of Sterile GauzeDURING the Third Stage ofLabor. MANAGEMENT OF THE THIRD STAGE OF LABOR. The third stage of labor commences at the complete expulsion of the fetus 01fetuses and ends at the complete expulsion of the placenta and membranes. Thepatient having been carefully assisted in turning from the lateral to the dorsalposture, the physician or nurse continues by gentle pressure, not kneading, of thefundus to Keep up and encourage firm tonic uterine contractions in order to pre-vent hemorrhage and the formation of an intrauterine clot. When the uterus does THE MANAGEMENT OF LABOR. 491 not seem to be doing its work properly, it may be necessary to use gentle frictionby a circular motion with the hand until contractions are resumed, or it mayeven be necessary to grasp the fundus vigorously and subject it to active manipu-lation in order to get a prompt respon
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
