The Prospective Mother, a Handbook for Women During PregnancySlemons, J. Morris (Josiah Morris)
Science
The Prospective Mother, a Handbook for Women During Pregnancy
Slemons, J. Morris (Josiah Morris)
Obstetrics; Pregnancy
Instances in which miscarriage is attributed to the use of some drug
are quite common, and we cannot dismiss them without a word of
explanation. Such cases generally fall into one of two classes. Often
a drug is given credit for efficiency where conception has been
erroneously suspected. Shortly after the menstrual date passes, some
medicine is resorted to, and the subsequent phenomenon, regarded as
the interruption of pregnancy, is really no more than normal
menstruation. In another group of cases miscarriage does actually
occur, although the medicine employed plays only a minor role in its
production. In such instances the irritation which the drug occasions
is the last link in a chain of events leading up to the miscarriage,
but the main factor lies in some fundamental imperfection in the
pregnancy. Physicians recognize a variety of these imperfections, and
know that they may be located in the womb, in the embryo, or in the
tissues which unite the one with the other. As an intimate knowledge
of pathology is often necessary to recognize the underlying, and
therefore the actual, cause of the miscarriage, it is not at all
surprising that patients frequently err in their interpretations of
such accidents, and emphasize unimportant matters.
It would lead us too far afield to attempt to discuss every cause of
miscarriage. Nevertheless, there are some very important ones, not
yet mentioned, which should be understood by the laity, as
appreciation of their significance may avert trouble. In some
instances, on the other hand, the accident is unavoidable; to know
this should afford the patient a large measure of comfort.
Irregularities in the position of the womb are often responsible for
miscarriage. Such a condition may exist in women who have not borne
children, but it is far more likely to occur as a result of
childbirth. After delivery, the enlarged womb becomes the seat of
intricate changes, the purpose of which is the restoration of the
organ to the condition which existed before conception. It dwindles
in size, and gradually drops to its accustomed location within the
pelvic cavity. Six weeks are usually required for these changes.
At the time of birth it is impossible to predict whether the womb
will finally resume a satisfactory position. Accordingly, an
examination two to four weeks later is essential. In four out of five
patients the organ will be found in its proper location, but, even
though it is not, suitable measures adopted at once will generally
serve to replace and hold it in good position. On the other hand, if
the malposition is not recognized until months or years later, simple
procedures will prove inefficient, and a surgical operation will
become necessary. Were there no other reason for a careful
examination at the end of the lying-in period, it would be amply
justified by the information which it gives relative to the position
of the uterus.
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