Pratique sage-femme; manuel de traitement . qui est caractéristique de cette attitude, peut facilement causer la distension de l'utérus flabby, et être folliquedby mort instantanée, de l'admission d'air dans les gapingmouths des sinus utérins au site placentaire. Abondant comme l'approvisionnement en sang du jarturientvagin récemment, ses vaisseaux sont individuellement si petits que hémorragesufectueux de causer l'alarme suit rarement même les plus extensivelacerations de cette partie du canal génital, mais suflReientlydeep larmes cervicales peuvent parfois causer une lacération de l'artère circulaire cir de l'artère du

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Practical midwifery; handbook of treatment . which is characteristic of this attitude, may easily cause distention of the flabby uterus, and be followedby instant death, from the admission of air into the gapingmouths of the uterine sinuses at the placental site. Abundant as is the blood supply of the recently jjarturientvagina, its vessels are individually so small that haemorrhagesufficient to cause alarm rarely follows even the most extensivelacerations of this portion of the genital canal, but suflReientlydeep cervical tears may occasionally cause a laceration of the cir-cular artery of the cervix, a vessel which is in most cases suffi-ciently large to be the cause of distinctly serious hfemorrhag-e. Treatment.—The only appropriate treatment of loss of bloodfrom either form of tear is the immediate repair of the lace-ration by properly placed sutures. These will be inserted mosteasily by a fully curved needle held at right angles to theshank of a proper needle-holder, two instruments which should PATHOLOGY OP LABOR. 2<S1. form a portion of every obstetricians outfit; l>ut if the physicianhas neglected to provide liiniself witli tlieni, or is timid aboutundertalving tlie iuniiediate repair of a deeply lacerated cervix inthe face of an existing lifemorrhage, and per-haps witli an insufficient hght and almostuseless assistants, the bleeding may bereadily controlled by the passage of anyfoinu of needle backward and forwardthrough the edge of the tear in such a waythat the spu/ting artery is entirely enclosedwithin the suture after its ends have beentied (Fig. 79). In most eases the cervix canbe seized by the fingers and drawn suffi-ciently near the vulva to permit the inser-tion of such a suture without the aid of theneedle holder. True Post-partum Hemorrhage.—This much more com-mon phenomenon is due to failure of the normal mechanism forits prevention; and a thorough comprehension of this process isso essential to the rational treatment of all forms of tru

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• bookcentury1800
• bookdecade1890
• bookyear18
• livresubjectmidwifery