. An American text-book of obstetrics. For practitioners and students. traceable to septicinfection. 934 AMERICAN TEXT-BOOK OF OBSTETRICS. Craniotomy of the Presenting Head.—After the bladder has been emptiedand the vulva and vagina disinfected, the patient should be placed on a tablein the dorsal position as for the forceps operation, an anesthetic administered,and the head steadied in the pelvis by pressure from above. Full dilatation ofthe cervix is advisable, but is not essential. Two fingers of the left hand arepassed up through the cervix to the presenting part, and held firmly against i
. An American text-book of obstetrics. For practitioners and students. traceable to septicinfection. 934 AMERICAN TEXT-BOOK OF OBSTETRICS. Craniotomy of the Presenting Head.—After the bladder has been emptiedand the vulva and vagina disinfected, the patient should be placed on a tablein the dorsal position as for the forceps operation, an anesthetic administered,and the head steadied in the pelvis by pressure from above. Full dilatation ofthe cervix is advisable, but is not essential. Two fingers of the left hand arepassed up through the cervix to the presenting part, and held firmly against itas a guide. Throughout the operation these fingers should guide the instru-ments and guard the maternal soft parts from injury. The perforator, held inthe right hand, is passed along the guide-fingers to a suture or a fontanelle ifpossible. The point should be kept at right angles to the presenting part, toprevent slipping, and the part selected for perforation should be nearer the sym-physis than the promontory (Fig. 533). Then, with steady pressure or a careful. Fig. -Perforation of the head begun: the right hand is grasping the handles of the tips should not be separated until after they have entered the fontanelle. boring movement, the point is made to enter the cranial cavity, and the perforator ispushed home as far as the shoulder-guard will permit. The opening is enlargedby compressing the handles so as to separate the blades. The instrument is thenclosed and withdrawn slightly to permit its being introduced again at rightangles to the first incision. The blades are again separated, then finally closedand withdrawn. By this means a crucial incision is made, through which ametal nozzle or crotchet can be introduced to break up the remaining steps of the operation will be more cleanly if a syringe isattached to the nozzle and the broken-down brain-matter is washed out withsterilized water. When the fetal skull is completely empti
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
