Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her BabyVan Blarcom, Carolyn Conant
Science
Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her Baby
Van Blarcom, Carolyn Conant
Infants -- Care; Maternity nursing; Pregnancy
Complete rest and physical relaxation are such effective preventive
measures that patients with a tendency to have abortions, who have been
willing to stay in bed throughout practically the entire period of
gestation, have gone through pregnancy without interruption, and been
delivered of normal babies at term. As out-of-door exercise is clearly
impossible in such cases, it is imperative that the patient keep her
room particularly well-ventilated all of the time, and, under the
doctor’s direction, have massage or bed exercises.
Since abortion seems to be due, so often, to excessively irritable
uterine muscle fibres that respond to even slight stimulation, a patient
who is known to have difficulty in carrying a child to term is usually
advised to avoid the marital relation throughout pregnancy.
Some patients with defective uterine lining will have slight bleeding
for a long time, possibly throughout the entire period of pregnancy,
because a small area of the placenta has separated, leaving, however, a
sufficiently large attached area to nourish the fetus. Such women
should, of course, be under a doctor’s care and sedulously avoid all
shocks to the uterine musculature, for the separated area may very
easily be increased to such a size that the fetus will be unable to
secure adequate nourishment, and die as a result. And the mother’s life,
too, may be endangered by hemorrhage from the separated surfaces.
To sum up in a word, we may almost say that, after pregnancy has begun,
preventive treatment consists of rest and avoiding physical shocks,
particularly during the first sixteen or eighteen weeks and at the time
when menstruation would occur were the woman not pregnant.
=Treatment=, in the different degrees of abortion, employed by most
physicians, is usually along some such lines as the following:
=1. Threatened.= A threatened abortion is one in which there is some
loss of blood, associated with pain in the back and lower abdomen,
but without expulsion of the products of conception. The treatment,
as a rule, is absolute rest in bed and the administration of
powerful sedatives.
=2. Incomplete.= An incomplete abortion is one in which the fetus is
expelled but the placenta and membranes remain in the uterine
cavity. The treatment is removal of the retained tissues, followed
by the same care that is given during the normal puerperium. Prompt
action in completing the delivery is important because of the
hemorrhage that usually persists until the uterus is entirely
emptied of its contents. Since the pregnant uterus is very soft, the
retained membranes are more often removed manually than
instrumentally, for a curette may be very easily pushed through the
uterine wall, and peritonitis would be likely to follow.
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