612 ACCIDENTS AFTER PARTURITION. 



When secondary or consecutive, it may result either from the extension 

 of the inflammation to the peritoneum, or the discharge of the lochia, 

 pus, etc., from the uterus. The escape of fluids is, of course, more 

 likely to take place when the rupture is inferior than when lateral or 

 superior. Death is nearly always the result of peritonitis or metro- 

 peritonitis. 



Treatment. 



The treatment of rupture of the uterus during parturition is generally 

 very unsatisfactory. Very little can be done to check the haemorrhage, 

 if it is great, and consecutive peritonitis is always a most serious 

 complication. 



If the foetus remains within the peritoneal sac, a favourable termina- 

 tion can scarcely be hoped for ; though in some rare instances, if air 

 does not obtain access to the cavity of the uterus or abdomen, it is 

 possible that the case may terminate in one of the various ways of extra- 

 uterine pregnancy. If the foetus is extracted, the rent may heal up ; 

 though this is very unlikely if the edges are much contused, and the 

 animal will, in all probability, perish from consecutive purulent 

 peritonitis. 



If the foetus is still wholly or partially in the uterus, it and its enve- 

 lopes must be extracted without delay, and as gently as possible ; as 

 haemorrhage w^ill probably only cease with the contraction of the organ. 

 If the uterus does not contract, but remains flaccid after removal of the 

 placenta, then it may be stimulated to do so by introducing the hand 

 into the interior for some time, after removing the coagula. If this 

 fails, and the rupture is not in the floor of the uterus, small pieces of 

 ice, cold water, or astringents may be introduced, and ergot of rye 

 administered ; a jet of cold water should be allowed to play upon the 

 loins, wherever the rupture may be. If there is hernia of the intestines, 

 these, of course, must be promptly returned into the abdominal cavity 

 before anything is done to the uterus. 



Some authorities advise that the uterus should be gently inverted, 

 brought outside the vulva, in order that the rent may be closed by 

 suture, and then returned. But this course is not to be recommended, 

 as it is very dangerous, and the wound will unite without sutures if 

 the organ contracts and no complications follow. 



The cavity of the uterus should be swabbed with a weak solution of 

 carbolic acid (1 to 100 — 250) or cresyl, and to prevent septic infection by 

 admission of air, a pledget of carbolised lint or tow should be placed 

 in the os or vagina, and changed now and again. 



Straining must be subdued by doses of opium or chloral, or the 

 subcutaneous injection of morphia, and the diet should be carefully 

 attended to. If there is constipation, mild laxatives and enemas may 

 be administered, Consecutive fever and peritonitis must be treated 

 by cold afl'usions, and large doses of anodynes — such as opium, as well 

 as counter-irritants. Metritis must be treated in the same manner, 

 by the gentle injection of cold water ; or the introduction of small 

 pieces of ice into the genital canal will be beneficial. Should symptoms 

 of septic infection appear, stimulants, with small doses of carbolic acid 

 and sulphite of soda, must be given. 



When the foetus has passed through the rent into the abdominal 



cavit}', delivery i^e?- vias naturales is then impossible, and the Ctesarian 



'section must be resorted to ; unless it be decided to allow the animal 



