The American text-book of obstetrics for practitioners and students . o grasp the lower uterine segment before the uterusis incised, and to compress it firmly with his hands until the child has beendelivered and the wound has been sutured. Hemorrhage into the abdominalcavity sometimes occurs subsequently from uterine inertia or faulty slight, it may be checked by an ice-bag over the uterus and a hypodermaticinjection of ergotin ; if abundant, the abdomen must be reopened, the clotsturned out, and the bleeding point secured. Before the uterine wound is finally OBSTETRIC SURGER V 149
The American text-book of obstetrics for practitioners and students . o grasp the lower uterine segment before the uterusis incised, and to compress it firmly with his hands until the child has beendelivered and the wound has been sutured. Hemorrhage into the abdominalcavity sometimes occurs subsequently from uterine inertia or faulty slight, it may be checked by an ice-bag over the uterus and a hypodermaticinjection of ergotin ; if abundant, the abdomen must be reopened, the clotsturned out, and the bleeding point secured. Before the uterine wound is finally OBSTETRIC SURGER V 149 closed some operators dilate the cervix from above and pack a .-trip \ iodo-form gauze centimeters (3 inches) wide and centimeters (?. feet) Iir_rinto the uterine cavity, passing tin- end through tin- cervix into the vagina, t>iprovide free drainage and t guard against intra-uterine hemorrhage by stimu-lating contraction. This practice is unnecessary in mosl cases unless the uterinemuscle is flabbv and weak and does not contract Fie. 2J7.—The deep suture i>luce<l as a running Fig. 2-J8.—The running stitches of the deep su- stitfli; it includes peritoneal and muscular coats, ture cut to form interrupted sutures (modifiedbut not decidual lining (modified from Grandin). from Grandin). The Uterine Suture.—Silver wire, silk, and catgut sutures are employed,but, on the whole, silk or well-prepared catgut seems to be preferable. Mu-toperators use two sets of interrupted sutures—a deep layer to approximate tIn-divided muscular coats, and a superficial layer to close the peritoneum. Thedeep sutures of No. 2 silk pass from 3 to 6 millimeters ( to -} inch) from theborder of the incision diagonally down through the muscular tissue to, but do PeritonealSuture
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Keywords: ., bookcentury1900, bookdecade1900, booksubjectobstetrics, bookyear1
