File:Obstetrics for nurses (1922) (14763258131).jpg

Identifier: obstetricsfornur00plasrich (find matches)
Title: Obstetrics for nurses
Year: 1922 (1920s)
Authors: Plass, Everett Dudley, 1886-
Subjects: Obstetrics
Publisher: New York, London, D. Appleton and company
Contributing Library: University of California Libraries
Digitizing Sponsor: Internet Archive

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ly repaired if they are of considerablesize, or if they cause bleeding. Multiple Incisions of the Cervix.—Multiple incisions of the cervixare occasionally employed when the cervical canal is obliterated, but theexternal os is only partially dilated and is so rigid that manual dilatationseems contra-indicated. The incisions are made radially with scissors,and are carefully closed with catgut sutures following delivery. Theprocedure is rarely used because of the danger that tearing may extend 316 TEXTBOOK OF OBSTETRICS FOR NURSES beyond the ends of the incisions during extraction of the child, and mayeven go deeply into the broad ligaments, and give rise to considerablerisk of serious hemorrhage and infection, not to speak of the difficultywhich may be experienced in their repair. Vaginal Hysterotomy (vaginal cesarean section).—Vaginal hyster-otomy is an operation designed to enlarge the undilated cervix by care-fully controlled incisions extending into the lower uterine segment. It
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Fig. loG.—Vaginal hysterotomy—incising the cervix. (WiUiams.) is particularly useful when it becomes necessary to empty the uterus earlyin pregnancy, but is rarely employed during the latter months, becausethe large size of the child necessitates such an increase in the size ofilie incisions that abdominal cesarean section Ixconu^s the sim()ler pro-cedure. It has the great advantage over other procedures employed forcnoctiiig a therapeutic abortion that the uterus can be emptied withina few minutes and does not entail forcible disruplion of the cervicaltissues. OBSTETRICAL OPERATIONS 317 Its tec-hnic is as follows: Tlu lervix is drawn toward the vulva bymeans of traction sutures of heavy silk i>asse(l through either side. Asmall transverse incision is matle through the mucosa at the upper partof the vaginal portion of the cervix and is joined by a longitudinal oneextending from a little above the urethra. Through these the bladderis separated from the cervix and lower uterine s

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