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Treatment of the Inevitable AbortionCategory: Obstetrics or Midwifery If the cervix is hard and the canal is not dilated, especially if the bleeding is free, the vagina should be packed full at once, if possible, with iodoform gauze. Rolls five yards long and two inches wide can be bought perfectly adapted to this purpose. A speculum should be used (Sims' or Graves') and the gauze should first be packed tightly into corners (fornices) around the cervix, then over the cervix and well down to the outlet. This should be held in place by a proper (T) bandage. The gauze can be removed in from twelve to twenty-four hours, and the ovum will generally be found lying upon the upper part of the packing, or in the canal that is now dilated, from which it can easily be removed. Sometimes it is necessary to repack and allow it to remain for another twelve hours as the canal has not been sufficiently dilated by the first packing. This packing not only causes the canal to dilate but usually stops the bleeding. After the ovum has been expelled an antiseptic vaginal douche should be given twice a day for a week or longer. If at the first examination the cervix is found softened and the mouth of the womb is open, but the womb has not yet expelled its contents, the sterile (clean) finger may be introduced into the womb and the ovum and membranes loosened and taken away, while this is being done counter pressure should be made over the abdomen. After the womb has been cleared of all its contents an antiseptic solution should be used, carefully, in the womb to wash it out, and this followed by washing out of the vagina. The after treatment is the same as that for labor at full term. The woman should remain in bed at least ten days. Next: Placenta Praevia Previous: Treatment of Threatened Abortion
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