Identifier: transactionsofam3319amer (find matches)
Title: Transactions of the American Association of Obstetricians, Gynecologists, and Abdominal Surgeons for the year ...
Year: 1920 (1920s)
Authors: American Association of Obstetricians, Gynecologists, and Abdominal Surgeons
Subjects: Gynecology Obstetrics Gynecology Obstetrics
Publisher: St. Louis : C.V. Mosby
Contributing Library: Columbia University Libraries
Digitizing Sponsor: National Endowment for the Humanities (NEH)

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sults wereso impressive that I began to do this type of operation in cases whereCesarean section was the indication of choice. Beck described an operation in an article entitled Observations on aSeries of Cases of Cesarean Section Done at the Long Island College 64 DOUBLE FLAP LOW CESAREAN SECTION RESULTS 65 Hospital During the Past Six Years. (American Journal of Obstetrics,Vol. lxxxix, No. 2, 1919), of which the essential features include a lowabdominal incision, stripping the bladder with its peritoneal coveringfrom the lower segment of the uterus, dissecting away the peritoneumfrom the uterus above the bladder incision, incising the uterus in thisexposed area, delivering the child, closure of wound in uterus and over-lapping the peritoneal flaps so as to seal the uterine wound. In all my Cesarean cases I have employed the transverse incision of theabdomen just above the pubes. To date the results have been satisfac-tory. All have healed by primary union. We have observed no hernia
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Fig. 2.—Upper or superior peritoneal flap made by dissection with blunt-pointed scissors. upon discharge from the hospital. I have placed the traction-sutures,one in the lower and one in the upper angle of the uterine incision, priorto opening the uterus. An assistant holds these sutures taut thus facili-tating the placing of the first row of deep sutures. The postoperative treatment consists in a low Fowler position of thebed, an ice-cap to the fundus of the uterus, which is possible only in thistype of section as the fundus is above the abdominal dressings, and adose of pituitrin or ergot. Because of the low situation of the dress-ings, the fundus of the uterus may be held by a nurse or an assist- 66 THURSTON SCOTT WELTON ant to prevent postpartum hemorrhage the same as after a sponta-neous delivery. CASE REPORTS* Case 1.—No. 12626. Primipara. In labor three days. Membranes ruptured twodays. Family physician made from four to six examinations a day through an un-clean vulva. Phy

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