Identifier: manualofpractica00davi (find matches)
Title: A manual of practical obstetrics
Year: 1895 (1890s)
Authors: Davis, Edward P. (Edward Parker), 1856-1937
Subjects:
Publisher: Philadelphia, P. Blakiston
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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ecessary to keep it there, pessa-ries. Continue treatment until uterus gets large enough toremain above the pelvic brim. Should impaction occur andobstruct discharge of rectum or bladder, the induction ofabortion mav become a necessary resort to save the womanslife. Retroversion of Uterus.—The fundus of the organ fallsover backward, while the cervix is tilted upward and forward,toward or over the pubes. Symptoms.—Pain in the back, numbness or pricking or un-steadiness in the lower limbs, and difficult or very painful 126 THE DISEASES OF PREGNANCY. defecation and micturition. The diagnosis is made on findingthe fundal tumor in its malposition by a digital examinationper vaginam, while the os and neck are tilted high up towardthe pubes. Prognosis.—Usually favorable from gradual spontaneousreplacement as the womb increases in size, but serious or fatalconsequences may arise from impaction of the growing organ(as in prolapsus) if it is not replaced during the earliermonths. Fig. 39.
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Retroversion at about twelfth week. Treatment must not be delayed. Empty the bladder by amale elastic catheter. If this is impossible, aspirate thebladder. Empty the rectum. Place the woman in the kn^-£lbow position, and restore the organ by gentle digital pressureeither by vagina or rectum, or both conjointly. Should manipulation fail, make gentle prolonged pressureby distending a soft-rubber bag in the vagina, or a Barness RETROVERSION OF UTERUS. 127 dilator in the rectum, the pressure thus induced being kept upfor several hours. After replacement a Hodge pessary maybe required to retain the womb in its normal position. Should all means fail to get the fundus above the sacralpromontory, abortion or premature delivery may be requiredto save the womans life. Fig. 39, page 126, from Leishman (after Schultze), showsretroversion of gravid womb at about twelfth week, with re-tention of urine and enormous distention of bladder, owing tothe urethra being dragged up and compressed by the di

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