Treatment of the Inevitable Abortion

Categories: 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.