Identifier: textbt00hirs (find matches)
Title: A textbook of obstetrics
Year: 1899 (1890s)
Authors: Hirst, Barton Cooke, 1861-1935
Subjects: Obstetrics
Publisher: Philadelphia : Saunders
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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rom collapse (rupture of uterus with hemorrhage) shortly after the expulsion of thefetus : , membranes still attached ; c, retraction-ring ; </, retroplacen-tal blood-clot; e, inverted placenta; f, contracted os externum; g, cord presenting. theory of a diminution in the area of the placental site, which theplacenta follows to a certain point, when, becoming solid by theapproximation of the villi and the obliteration of the lacunae, it 39^ THE MECHANISM OF LABOR. can no longer follow the contraction and retraction of the uterus,and is sprung off from the uterine wall. It requires usuallyseveral pains to accomplish this result ; so that the placenta is not, as a rule, completely detached until about fifteen minutesafter the delivery of the child, when it may he found lying inthe dilated pouch of the lower uterine segment and cervicalcanal. The walls of this portion of the birth-canal are so flaccidfrom pressure paralysis and overdistention that the placenta
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kC* :_^ : it Fig. 259.—Credos method of expressing the placenta (photographed from nature 1 11 >ickinson 1. might remain there many hours, perhaps days, unexpelled.Hence it is that artificial assistance is almost always requiredto express the placenta. The placenta is usually expelled likean inverted umbrella, the fetal surface coming first with themembranes trailing after it. It occasionally, however, escapes Abnormalities in the Mechanism of the Third Stage ofLabor.—Retention of the placenta occurs very frequently. A.Sthe placenta is fully separated, the hemorrhage is slight. The MEC1IAX1SM OF THE THIRD STAGE 01 LABOR, 397 placenta simply lies in the dilated lower uterine segment and theupper portion of the vagina. The treatment consists of the proper application of Credes method of expression. Sometimes the placenta lies across the

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