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Abortion, Miscarriage, Premature Labor. (Accidents of pregnancy)





Category: Obstetrics or Midwifery

These
three terms indicate a premature expulsion of the products of conception.
Let us medically define these terms as follows; Abortion implies expulsion
of the foetus before the sixteenth week. Miscarriage, the expulsion
between the sixteenth and twenty-eighth weeks. Premature labor designates
the time of expulsion as between the twenty-eighth week to within a few
weeks before the normal termination of pregnancy. Miscarriage is the term
popularly used for the accidental loss of the products of conception.
Abortion, in the popular mind, expresses the intentional loss of the
products of conception. Abortion in the medical sense, takes place about
once in every four or five pregnancies. It occurs more frequently in those
who have borne children, occurring generally in the third or fourth
pregnancy, or toward the end of the child-bearing period, and it takes
place more frequently between the ninth and sixteenth week, when the
after- birth is in process of formation; and it is more liable to occur at
the time of the month when the normal menstruation would be due. It should
be borne in mind also that abortion occurring at this period is quite
dangerous to the mother's future health, and also dangerous to life; so
that at the first indication of abortion a physician should be called for
this trouble, because it needs care, both to prevent it and to assist the
woman to a successful ending when it is impossible to prevent it. This is
more dangerous to life than confinement at full term, and is apt to leave
behind a tendency to recurrence at the same time in the future
pregnancies, and also makes the woman liable to inflammatory conditions of
the womb.

Causes. Abortion may be induced by many causes due to the mother, father,
and child. Among maternal causes may be mentioned any serious disease,
especially fevers, when accompanied by a rash on the skin, such as
smallpox, measles, scarlet fever. It is hard for a pregnant woman to go
through one of these diseases, without having an abortion. Syphilis,
tuberculosis, malaria, organic heart and kidney disease, diabetes, anemia,
and systemic poisoning also are causes; nervous disturbances as shock,
fright, sorrow, convulsions, chorea; mechanical causes, violent exercise,
lifting, blows, falls, coughing, vomiting; local causes, as wrong position
of the womb, inflammation of the womb, etc.; all are causes.

Causes. Due to the Father. Paternal. Syphilis, alcoholism, lead
poisoning, excessive venery, extremes of youth or old age.

Foetal Causes. Disease of the after-birth, other parts, of cord, death of
the foetus, placenta pravia, and yet many women are subjected to falls,
blows, etc., who carry their child to full term.



Symptoms. These vary with the period of pregnancy where they occur. In
the earlier months the symptoms are those of profuse menstruation,
sometimes accompanied by more pain perhaps than usual. The ovum is then so
small that it escapes notice. In the profuse flow there may be
unaccustomed clots of blood; when this trouble occurs later in pregnancy
there are two constant symptoms which, together with the history of the
case, render the diagnosis easy. These prominent and constant symptoms are
pain and bleeding. The symptoms may be preceded by a bearing down feeling
in the lower abdomen, with backache, frequent calls to pass urine, and a
discharge from the vagina, that is a mixture of mucus and water. After
these symptoms last for a shorter or longer time, labor pains set in, the
bleeding increases and the contents of the womb are discharged. The ovum
may be expelled whole when it looks like a huge blood clot, or it may be
expelled partly and the membranes left behind; or the embryo (child)
alone, surrounded by the transparent membrane, escapes.

If the after-birth has formed it may be cast off entire or piecemeal. The
embryo (child) alone may escape, the neck of the womb contracts and shuts;
bleeding persists for an indefinite period, for weeks and weeks, until the
health of the poor woman is seriously affected. Persistent bleeding of
this kind is almost always due to the retention of portions of the
after-birth or membranes, and should prove to the woman that there is a
serious condition existing which should be speedily corrected. A physician
should be called who should make a thorough examination; and if such a
condition as above described is found, should free the womb from its
retained products, which are not only sapping the woman's life, but also
rendering the future health of the womb very uncertain.





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