http://www.youngasianescorts.co.uk/?baletos=%D8%A7%D9%84%D8%AE%D9%8A%D8%A7%D8%B1%D8%A7%D8%AA-%D8%A7%D9%84%D8%AB%D9%86%D8%A7%D8%A6%D9%8A%D8%A9-%D8%AE%D9%88%D8%A7%D8%B1%D8%B2%D9%85%D9%8A%D8%A9-%D8%A7%D9%84%D8%AA%D8%B4%D8%AE%D9%8A%D8%B5&98e=3f الخيارات الثنائية خوارزمية التشخيص Dr. Paranjothy had a set of rules that none of us dared ignore.
http://www.amisdecolette.fr/?friomid=site-de-rencontre-pour-musulman-en-belgique&44c=cc When a patient goes into Labour, Student, she would say, make sure she is well hydrated and empties her bowels and bladder. A full bladder and a full bowel prolongs and obstructs labour.
http://documentalqueridowatson.es/pizdyhov/3658 Prolonged and obstructed Labour cause VVFs
http://unikeld.nu/?ioweo=opzioni-binarie-sentiment&0e7=7a This is easier said than done. When a patient is in labour and her uterine contractions have blocked all reason out, the last thing she wants to hear, is anyone else’s advice about her body functions. Especially, since none of us, as medical students, could speak with authority on the subject.
see The Birth canal, the Bladder and the Rectum are in close proximity and aligned in front of each other. The descending head of the baby, could cause the patient to have retention of urine and the patient would find it difficult to pass urine as labour progressed. If this was allowed to happen for a long time, the prolonged pressure of the baby’s head on the the mother’s bladder could cause the dreaded VVFs, Vesico-Vaginal fistula.
http://www.topcanon.fr/figase/opie/1340 A VVF is a nightmare that occurs when the tissue between the mother’s bladder and vagina sloughs under prolonged pressure, creating a fistula, an unnatural passage , between the bladder and the vagina. Urine produced continuously in the kidney flows to the bladder, to be stored before voiding. With no intact bladder to store urine before voiding, there would be a constant dribble of urine from the bladder to the vagina, ending in a continous trickle down the lady’s legs, for the rest of her life, declaring her a social outcast, with no love life to talk about. We are talking of the early 60s when diapers were not fashion accessories.
binäre optionen brokerjet VVFs do not heal spontaneously. VVFs required surgical correction, sometimes in expensive stages, often making it astronomically expensive and out of the reach of the poorer women in rural areas, who unfortunately were the ones who were prone to VVFs, with their multiple pregnancies, with no antenatal or Obstetric Care.
http://gtheal.com/?marakanr=childfree-dating-sites-uk&55e=78 When she was in the Labour Room, Dr. Paranjothy would make sure that all the patients voided spontaneously. They were not catheterised, unless there was no other option, as instrumentation usually caused infections.
site de rencontre pour les amoureux de la nature Student, go and open the tap in the bathroom,
Leave it on half open, she would say. make sure its half open,
The sound of dripping water will encourage the patient to pass.
She was right. The patient would pass eventually.
The only problem was, that the rest of the nongravid bladders in the Labour Room, would also come under the influence of the sound of the dripping tap eventually.
We would run upstairs to the Attic as soon as we could, cross legged, taking the steps two at a time, with bladders reaching our clavicles.
As medical Students in the early 60s, we saw many cases of VVF. As PGs in the late 70s, we did not.
Fortunately, with better Antenatal Care and Good Obstetric practices reaching the rural population ,VVFs are seen only occasionally, if at all.
I know Dr.Paranjothy’s dripping tap helped the Labour Room patients in the early 60s.