Case of spontaneous inversion of the uterus occurring immediately after delivery : with remarks / by J.G. Wilson.

  • Wilson, J. G. (James George)
Date:
[between 1860 and 1869?]
Catalogue details

Licence: Public Domain Mark

Credit: Case of spontaneous inversion of the uterus occurring immediately after delivery : with remarks / by J.G. Wilson. Source: Wellcome Collection.

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    down description, which were soon followed by alarming symptoms of sinlcing and exhaustion, bordering on syncope or collapse. The countenance became pale and anxious, the skin cold, and the pulse hardly perceptible; there was also considerable nausea and retching. There was no haemorrhage of any consequence, not more than usual in natural labour. On placing my hand over the supra-pubic region in order to ascertain the condition of the womb, I was surprised to find no uterine tumour, but in the situation it ought to have occupied there was an impression conveyed to the hand of a most unusual void or want. On proceeding to make a vaginal examination there was found a large globular tumour protruding several inches beyond the vulva, which proved to be the uterus in an inverted state. The inversion of the uterus appeared to be quite complete and was accompanied, as it usually is, with inversion of the vagina. The placenta was found to be firmly adherent to the inverted fundus. After the administration of brandy, ammonia, &c., so as to revive the patient a little from the shock communicated to the system in consequence of the accident, I proceeded without farther delay to attempt reduction of the inverted organ. I endeavoured to r(5place the uterus before removing the placenta, but soon found that the bulk of the tumour was such as to preclude the possibility of this being done. I accordingly very cautiously peeled off the placenta from the inverted fundus, and thus considerably reduced the size of the tumour. The removal of the placenta only occupied a few seconds, and was not accompanied or followed by any haemorrhage of consequence. I now firmly grasped the protruded uterus with the hand (so as to empty the vessels of the organ by compression) and pressed it gently through the vaginal orifice. As soon as the vagina was put upon the stretch, gentle and steady pressure was applied by the hand principally upon the fundus. This pressure had not been long continued when it became obvious that some progress towards reduction was being made. The uterus was found gradually to recede, and by still maintaining the pressure in the axis of the inlet of the pelvis, the uterus was found to start or bound suddenly from the hand, “like a bottle of india rubber when turned inside out.” The restoration of the organ was now found to be complete. The hand was introduced into the cavity of the uterus, and retained there for several minutes; this was done not only for the purpose of guarding against any recurrence of the inversion, but also of exciting more active contractions by its presence. On now placing the hand over the hypogastric region, the uterus was found firmly and well contracted just as after normal delivery. From this time all the symptoms of collapse