Identifier: obstetricsfornur00plasrich Title: Obstetrics for nurses Year: 1922 (1920s) Authors: Plass, Everett Dudley, 1886- Subjects: Obstetrics Publisher: New York, London, D. Appleton and company Contributing Library: University of California Libraries Digitizing Sponsor: Internet Archive

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Text Appearing Before Image: chronicnephritis. Various methods are available for preventing the possibilityof subsequent gestations, but the one most frequently employed consistsin doubly ligating and cutting both fallopian tubes, and ))urying theiruterine ends l)etween the folds of tlie broad ligaments. OBSTETRICAL OPERATIONS 331 Pubiotomy and Symphyseotomy.—Pubiotomy and symphyseotomy areoperations devised for temporarily increasing the size of the pelvis suffi-ciently to permit the extraction of the child, when the existence ofmoderate degrees of disproportion renders vaginal delivery impossible.In the former, the cartilage of the symphysis pubis is severed with aheavy knife, while in the latter, the pubic bone is sawed through witha Gigli saw. In either event, the ends of the pubic bones gape severalcentimeters, with the result that the pelvic cavity is so increased insize that delivery can be accomplished by forceps or version and extrac-tion. These procedures are now so rarely employed that it is needless

Text Appearing After Image: Via. 144.—Pubiotomy—the Gigli saw in position. (Williams.) to descri1)e their technic, and are practically limited to moderate gradesof pelvic contraction, in which the degree of disproportion has beenunderestimated and the true extent of the dystocia only realized aftera prolonged test of labor. In this event, these procedures may be utilizedinstead of sacrificing the uterus or the child. These operations necessitate rather elaborate after-care, which in-cludes the use of heavy bands of adhesive plaster around the hips, andtlie employment of a Bradford frame to permit the common nursing-attentions. Patients are usually kept in bed three weeks, by which timefibrous union between the bones has become established, so that a normallife ciiii be gra(hially resumed. Destructive Operations.—These are formerly resorted to in many casesof obstructed labor, even though the child \\as alive; but, witli thedevelopment of modern obstetrical surgery, the field for their employ- 332 TEXTBOOK

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