A textbook of obstetrics . osture over a chair to guard a prolapsed cord from pres-sure and to facilitate its reposition (Dickinson). prolapsing again, which is extremely likely. The whole handmust be inserted in the vagina, and perhaps within the loweruterine segment; so that anesthesia is usually required. While the anesthetic is administered, and while the physician makes hispreparations for the reposition, the patient should be kept in theTrendelenburg posture, so as to guard the cord from fatal pres-sure. If the cord is satisfactorily replaced so that it will notcome down again, forceps s
A textbook of obstetrics . osture over a chair to guard a prolapsed cord from pres-sure and to facilitate its reposition (Dickinson). prolapsing again, which is extremely likely. The whole handmust be inserted in the vagina, and perhaps within the loweruterine segment; so that anesthesia is usually required. While the anesthetic is administered, and while the physician makes hispreparations for the reposition, the patient should be kept in theTrendelenburg posture, so as to guard the cord from fatal pres-sure. If the cord is satisfactorily replaced so that it will notcome down again, forceps should be applied to the head to f\x itfirmly over the pelvic inlet. If manipulation fails to replace thecord, podalic version should be performed without waste of breech being firmly impacted in the pelvis, the ease is man-aged as one f breech presentation—by delay until the os is well L IBOR COMPLICATED BY ACCIDENTS AND DISEASES. 3/ D and then by rapid extraction. g and is engaged so that version is out. Fig. 450.—Impro-vised repositor. dilated and the cervix paralyzed If the head is presentin of the question, the cord should be so disposed as to be least pressed upon (for example, opposite the left sacro-iliac junction in a left occipitoanterior position of a vertex presentation) and the head rapidly extracted with forceps. In prolapse of the cord with a breech presentation, the cord should be replaced by manipulation in the Trendelenburg posture; a foot should be seized and brought down until the breech is firmly impacted in the pelvis. The instrumental reposition of the cord isusually unsatisfactory and unnecessary. Man-ipulation accomplishes more than can be doneby a repositor. Occasionally, however, it mightbe convenient to remember the device illustratedin figure 450. A loop of string- or tape is tieddouble around the end of a stiff catheter orbougie. The free loop is caught over the cordand the end of the instrument which is carriedhigh up into the uterine
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