There is no dispute as to the desirability of repairing the pelvic floor, posterior vaginal wall and perineum in the puerperium, although there is ample room for improvement in the manner of doing it in general practice. The old custom of immediate repair, even before the placenta is expressed, as one authority recommends, must be unlearned. The necessity for as careful a preliminary vaginal examination as any expert gynecic surgeon would make before attempting a secondary repair must be appreciated and the operation itself must be conducted like any other vaginal operation with a good table, proper implements and sufficient assistance if women are to be spared the secondary operations to which thousands of them are now subjected.
It has been demonstrated by ample clinical experience that the cervix may be repaired with perfect success and with entire safety to the patient during puerperal convalescence, not only in well-appointed hospitals
HIRST BC. INJURIES TO THE ANTERIOR VAGINAL WALL IN LABOR.THEIR PRIMARY, INTERMEDIATE AND SECONDARY REPAIR. JAMA. 1904;XLIII(20):1431–1432. doi:10.1001/jama.1904.92500200001
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