. Obstetrics for nurses. , and under no cir-cumstances should it be left inplace longer than twenty-fourhours. Manual Removal of the Pla-centa.—Occasionally, l)y reasonof hemorrhages from the par-tially separated placenta, orwhen the placenta is abnor-mally adherent, it becomes nec-essary to remove it this purpose the patient should be anesthetized, and each step of thel)rocedure carried out under the most rigorous aseptic technic. Ilicoperators hand is passed along the umbilical cord into the uterine cavity,until the margin of the placenta is reached. Then, the back of thehand be
. Obstetrics for nurses. , and under no cir-cumstances should it be left inplace longer than twenty-fourhours. Manual Removal of the Pla-centa.—Occasionally, l)y reasonof hemorrhages from the par-tially separated placenta, orwhen the placenta is abnor-mally adherent, it becomes nec-essary to remove it this purpose the patient should be anesthetized, and each step of thel)rocedure carried out under the most rigorous aseptic technic. Ilicoperators hand is passed along the umbilical cord into the uterine cavity,until the margin of the placenta is reached. Then, the back of thehand being in contact with the uterine wall, with a lateral motion ofthe fingers, the placenta is peeled away along ilio usual line of cleavageIhrough llio docidua. and, when completely separated, it is grasped byIho liiiiid ;iii(l slowly oxtradcd. Fioni the standpoint of infection, thisis the most dangerous procedure in obstetrical practice, since the handcomes in direct contact with the raw surface of the uterine wall. Con-. 130—Packing the uterus. (Williams.) OBSTETRICAL OPERATIONS 311 sequently, very particular attention mnst be paid to all aseptic details,and the operation must be avoided, whenever possible, by the employ-ment of less dangerous maneuvers. The Bougie.—A bougie is a heavy walled rubber tube from one totwo centimeters (-/g to V5 inch) in diameter, and 13 to 14 inches long,with a blunt end, and is used to inaugurate uterine contractions, whenit is desired to induce labor, and when the cervix is not dilated suffi-ciently to admit a Voorhees bag. Its action is purely mechanical, in
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectobstetrics, bookyear1
