Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
The iodine treatment of Hensler is simple and often effective. If no
skin changes are visible and but little leucorrhœa, the vulva is
thoroughly prepared as for a vaginal operation, dried and painted with a
10 per cent solution of tincture of iodine. Generally one application
suffices, but when the leucorrhœa is bad, it may be necessary to repeat
the treatment on the third and fifth day thereafter. Between treatments,
the vulvar surfaces and even the vaginal walls (by insufflation) are
kept dry with zinc oxide powder. If all measures fail and exhaustion is
imminent, emptying the uterus may be advisable.
=Herpes= is an inflammatory, superficial eruption, characterized by red
patches, blisters, or pustules. It is accompanied by burning, itching,
and nervous depression. The origin is probably toxic and the termination
may be fatal. Milk diet, soothing lotions, and, if necessary, abortion,
constitute the means of treatment.
=Areas of pigmentation= (the chloasmata) are not amenable to treatment.
They usually disappear after labor.
=Albuminuria of Pregnancy.=—Albuminuria is so common as to be almost
physiological when the amount of albumin is small. When the amount of
albumin in the urine is large, it may be due to pre-existing disease,
which is first discovered when the urinalysis is made during pregnancy.
(Chronic nephritis?).
If it makes its debut during gestation and continues as a mere trace
without casts, it is spoken of as the albuminuria of pregnancy, but the
patient must be watched with great care, since the albuminuria may be a
premonitory sign of eclampsia.
Albuminuria and eclampsia must be considered together, because, while
the two conditions may exist separately, they are most frequently
associated, and it is believed that they have a common causation. It is
true that most cases of albuminuria terminate favorably, yet the higher
the albumin content, the greater the danger of eclampsia.
Albumin appears in the urine in from three to five per cent of all
pregnancies. It is more common in the latter half of gestation and the
attacks differ greatly in severity.
_Symptoms._—In the early stages the urine shows an abundant, pale fluid
of low specific gravity.
The seriousness of the case is generally indicated by the amount of
albumin, although this is not a reliable guide as to the danger of
eclampsia. Casts and red and white blood corpuscles are occasionally
found. The output of urea usually remains normal, but diminution usually
occurs in connection with eclampsia. Anæmia and anasarca are common, but
it is a hopeful clinical sign that the cases of extensive edema rarely
develop eclampsia.
In albuminuria of pregnancy there is a large fœtal mortality which, to a
degree, is independent of eclampsia. The infant dies _in utero_ or is
born feeble, or prematurely.
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