Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
=Malformation of the uterus= may possess an obstetric interest at times.
The double uterus (uterus didelphys) and the uterus with a rudimentary
horn (uterus bicornis) are examples. These are congenital conditions,
due to imperfect development, and pregnancy may take place in one or
both sides. If in one side only, the other half will also exhibit the
softening and other changes as in normal cases. Binovular twins may be
the result of a pregnancy in each side.
=Pressure Symptoms.=—_Edema_ of legs and sometimes of the vulva occurs
during the last trimester. It is due to increased intraabdominal
pressure and to direct interference with the return circulation by the
pressure of the heavy uterus on the iliac veins at the brim of the
pelvis. The urine should be examined for albumin and the patient put in
the horizontal position if the edema is troublesome.
_Varicose veins_ of legs and vulva may cause much distress. The limbs
should be bound with flannel spirals or with rubber bandages in the
recumbent position, or elastic stockings may be obtained. Operation
during pregnancy is not to be considered. The vulva can only be relieved
by a double bandage, which is sewed at the point where it crosses the
vulva, and buckled or tied to a waistband above the hips, both before
and behind. This brings support to the vulva. If the veins rupture, the
part should be elevated and compressed with an aseptic pad.
_Hæmorrhoids_ may either appear or grow worse late in pregnancy. If they
protrude, they should be replaced. Ointments and iced applications may
be used and the bowels kept loose.
_Cramps_ may occur in the muscles of the legs, due sometimes to the
varicose veins and sometimes to pressure on the lumbosacral plexus.
=Moles.=—Mole is the name given to an ovum which is destroyed by disease
of its coverings during the early months of gestation. Two kinds are
known, the blood mole (carneous mole, fleshy mole, or hæmatoma mole) and
the hydatidiform mole (vesicular mole).
The blood mole results from progressive or recurrent slight hæmorrhages
during the first three months of pregnancy, but hæmorrhages insufficient
in quantity to produce an abortion. The blood forms a clot, which may be
retained for several months and become solidified.
Hydatidiform mole is a disease of the young chorionic villi,
characterized by the growth of an immense number of irregular clusters
and chains of grape-like cysts from the very minute to bodies
four-fifths of an inch in diameter. The causation is unknown.
Both forms occur in the first half of the pregnancy and are
characterized by undue enlargement of the uterus and hæmorrhagic
discharge.
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