A manual of practical obstetrics . Spontaneous evolution. First stage. While spontaneous rectification and version are usuallyascribed to uterine contraction, it is probable that they arepromoted by antero-lateral pressure of the womans thighsupon the abdomen, when she assumes a sitting, kneeling, orsquatting posture. SPONTANEOUS EVOLUTION. 229 Spontaneous Evolution.—The childs body remainscrosswise to the pelvic brim. The head rotates {above thebrim) toward the nearest acetabulum, the breech toward theopposite sacro-iliac synchondrosis. The arm is extended fromthe vagina, the shoulder descend
A manual of practical obstetrics . Spontaneous evolution. First stage. While spontaneous rectification and version are usuallyascribed to uterine contraction, it is probable that they arepromoted by antero-lateral pressure of the womans thighsupon the abdomen, when she assumes a sitting, kneeling, orsquatting posture. SPONTANEOUS EVOLUTION. 229 Spontaneous Evolution.—The childs body remainscrosswise to the pelvic brim. The head rotates {above thebrim) toward the nearest acetabulum, the breech toward theopposite sacro-iliac synchondrosis. The arm is extended fromthe vagina, the shoulder descends into the pelvic cavity, theneck rests behind the symphysis pubis. The body is thendoubled laterally on itself, breech and head approaching eachother (just as one might press together the two ends of asausage), while the rounded, convex angle of duplication isforced down through the pelvic cavity to the inferior strait. Spontaneous evolution. Second stage. The side of the child (the side of its chest) is born first, fol-lowed by breech, legs, and feet, which are successively forceddown along the sacrum and emerge at the perineum. Unlessthe pelvis is large, the child small, and uterine contractionstrong, foetal impaction is apt to occur, or the child is borndead from the prolonged and violent compression to which it 230 TRANSVERSE PRESENTATIONS. has been subjected. See Fig. 90, page 227, representing acase as exhibited by frozen section of cadaver (after Barnes).When the process is successful its several stages are thoseshown in Figs. 91, 92, and 93. Causes of Transverse Presentation.—Prematurity ofthe labor. Placenta prsevia. Narrowness of pelvic lateral obliquity of the uterus. Multiple mobility of the child from excess of liquor amnii. Fig. 93.
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