The trend of modern obstetrics

Abstract

Among the foregoing are included some advances in treatment whose place of permanence is already guaranteed. One of these is the treatment of central (and some marginal) placenta praevia by Caesarean section, and another is the treatment of acute hydramnios by the withdrawal of amniotic fluid through the abdominal wall. An ideal treatment of other conditions—I mention the toxaemias of pregnancy—has not yet been found. I must mention one condition in which patients are lost: I refer to post-partum haemorrhage. Grave as this condition is, its gravity is often increased manifold by the ill-advised, ill-directed attempts at Crede; ignorance of its many pitfalls is one of the main causes, potential or actual, of death in the third stage of labour or soon afterwards. I do not wish to be disrespectful to the memory of its author, but, instead of being taught as Crede’s manoeuvre, far better to call it Crede’s attack or Crede’s assault, when its potential seriousness and incidentally its many limitations will be better understood. The third stage of labour needs to be thoroughly understood in detail by every doctor practising midwifery. I invariably demand an accurate and detailed knowledge of the third stage from every postgraduate who seeks his L.M. diploma.