Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating itBurns, John
Science
Observations on Abortion: Containing an account of the manner in which it is accomplished, the causes which produced it, and the method of preventing or treating it
Burns, John
Miscarriage
When the membranes come to occupy more of the uterus, and a still
greater difference to exist betwixt the placenta and decidua, we have
again a change of the process; we have more bearing down pain, and
greater regularity in its attack; we have a more rapid discharge, owing
to the greater size of the vessels; but there is not always more blood
lost now than at an earlier period, for coagula form readily from
temporary fits of faintness and other causes, and interrupt the flow
until new and increased contraction displaces them. Often the membranes
give way, and the fœtus escapes with the liquor amnii, whilst the rest
of the ovum is retained for some hours or even days, when it is expelled
with coagulated blood separating and confounding its different parts or
layers. At other times the fœtal and maternal portions separate, and the
first is expelled before the second, forming a very beautiful
preparation. In some rare instances we find the whole ovum expelled
entire, and in high preservation. After the expulsion, the hemorrhage
goes off, and is succeeded by a discharge somewhat resembling the
lochia.
In cases of twins, after one child is expelled, either alone or with its
secundines, the discharge sometimes stops, and the woman continues
pretty well for some hours, or even for a day or two, when a repetition
of the process takes place, and if she have been using any exertion,
there is generally a pretty rapid and profuse discharge. This is one
reason, amongst many others, for confining women to bed for several days
after abortion.
There is generally, for a longer or shorter time before the commencement
of abortion, a pain and other irregular actions in the neighbouring
parts, which give warning of its approach before either discharge or
contraction take place, unless when it proceeds from violence, in which
case the discharge may instantly appear. This is the period at which we
can most effectually interfere for the prevention of abortion.
I need not be particular in adding, that we are not to confound these
symptoms with the more chronic ailments which accompany pregnancy.
Similar disturbances in the action of the neighbouring parts are very
commonly found to precede labour at the full time; and even then we may,
by proper means, postpone or retard expulsion for some hours or days.
A great diversity obtains in different instances with regard to the
symptoms and duration of abortion. In some cases the pains are very
severe and long continued; in others, short and trifling. Sometimes the
hæmorrhage is profuse and alarming: at other times, although
circumstances may not be apparently very different, it is moderate or
inconsiderable. Often the sympathetic effects on the stomach and bowels
are scarcely productive of inconvenience, whilst in a greater number of
instances they are very prominent symptoms.
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