Depressive reactions following hysterectomy.
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Biomedical subjects
Publications and source records attributed to G F MELODY.
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Paravaginal hematoma is an unavoidable obstetrical complication, usually due to the traction and rupture of paravaginal veins by the oncoming presenting part. Pain, swelling, ecchymosis and urinary retention are the usual symptoms if the hematoma is located below the levator plate, while supralevator hematomas give no external manifestations. Early diagnosis could be made more often if digital examination of the pelvis were done routinely after the third stage of labor and before dismissal of the patient from the hospital, and done more frequently in postpartum patients with pelvic complaints. Active surgical intervention is advocated to avert needless destruction of tissue, prolonged morbidity, and delayed recovery.
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Postpartum hemorrhage is the outstanding cause of maternal mortality, and a redoubtable contributor to puerperal death from other causes, notably infection and renal failure. The clinical situations in which hemorrhage is liable to occur must be better known, so that anticipatory and preventive measures can be taken. Recent knowledge about defibrinated blood in women with degenerative changes at the placental site must be incorporated in the thinking and practice of physicians dealing with obstetrical cases. The indications, limitations, and hazards of the various anesthetic methods available for parturient women should be carefully considered in the circumstances of each case.
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