A Sketch of the Management of Pregnancy, Parturition and the Puerperal State (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1888. Excerpt: ... THE PUERPERAL STATE. NORMAL. The placenta and membranes having been delivered, the hand is to be kept gently pressed over the fundus uteri, from time to time making slight circular friction to ensure the expulsion of any clots which may form and be retained to afterwards cause afterpains, until the uterus becomes permanently contracted and retracted. This will be in from a half-hour to an hour. Then the patient is to be cleansed about the genitals and to have a binder applied with moderate firmness. The binder should extend from about the tenth rib to below the trochanters and be worn nine or ten days. It is a source of much comfort and benefit by sustaining the relaxed abdominal walls and increasing the intra-abdominal pressure. Experience teaches that a properly (equably) applied binder tends to prevent subsequent pendulous, flabby abdominal walls. A wad of absorbent cotton or oakum covered with muslin should be placed over the vulva and held in place by a broad bandage fastened in front and behind to the binder. This is removed to permit of defecation and urination. The vulva should be gently cleansed with warm water every six hours and the absorbent wad renewed. The urine should not be drawn except where, after trial in different positions, the woman can not pass it herself. The bladder should be frequently emptied for twelve hours after labor; for when at all distended it increases greatly the liability to relaxation of the uterus and hemorrhage. When necessary to employ the catheter it should be passed by inspection and not by touch, the parts being first carefully cleansed from lochia, and the catheter kept aseptic; neglect of these precautions will result in cystitis. If the bowels do not move by the third day, give some pleasant cathartic and aft...