CESAREAN SECTION IN THE SOW 139 



permit the escape of fluids which would contaminate the 

 abdominal wound or possibly the peritoneum, the re- 

 maining fetuses are removed by way of the same in- 

 cision. This is accomplished by digital manipulation 

 of the horn, — an assistant is of much help at this stage 

 of the operation, — and after having evacuated the con- 

 tents of this horn, the other one is brought to the sur- 

 face. If possible its contents are crowded out and by 

 gentle manipulation the fetuses are extracted by way 

 of the incision first made. 



If attachment of the placental membranes prevents 

 the transferring of the contents of the second horn 

 across and by way of the body of the uterus through 

 the first horn and out through the incision made 

 therein, it is necessary to make a second opening for 

 the purpose of removing the fetuses directly out of 

 the horn in which they are contained. 



After having removed all fetuses, any portions of 

 fetal membranes are carefully removed, and by means 

 of dressing forceps and cotton the interior of the 

 uterine horns and the body of the uterus are carefully 

 swabbed, removing, if possible, all of the' contents. 

 This having been accomplished, the two incisions made 

 into the horns of the uterus are closed, using for this 

 purpose chromic gut and uniting the wound margins 

 with a Lembert suture. 



After having mopped the wound margins with 

 pledgets of cotton taken from the working solution, 

 the uterus and horns are returned into the peritoneal 

 cavity, and the wound margin is likewise cleansed of 

 any possible contaminating materials and sutured as 

 just described in hysterectomy. 



After-Care. — In some cases there is marked evidence 

 of shock following a cesarean operation, and a hypo- 



