. The science and art of midwifery. he retreat of a con-siderable portion of the cerebro-spinal fluid into the spinal canal. Allthese changes are induced rapidly, and are not dependent upon theactivity and strength of the uterine pains. The method of performing version and extraction in contractedpelves is, with few modifications, the same as in pelves of normal contracted pelves great care requires to be taken lest the arms be-come reflected upward to the sides of the childs head, or crossed uponthe neck. To avoid this difficulty it is desirable to introduce thehand over the abdomen o
. The science and art of midwifery. he retreat of a con-siderable portion of the cerebro-spinal fluid into the spinal canal. Allthese changes are induced rapidly, and are not dependent upon theactivity and strength of the uterine pains. The method of performing version and extraction in contractedpelves is, with few modifications, the same as in pelves of normal contracted pelves great care requires to be taken lest the arms be-come reflected upward to the sides of the childs head, or crossed uponthe neck. To avoid this difficulty it is desirable to introduce thehand over the abdomen of the child, and bring down the arms beforethe engagement of the shoulders. In extracting the head, tractionsmay be made upon the lower extremities and shoulders according tothe method of Kiwisch, or they may be made with one hand uponthe shoulders, while two fingers of the other are inserted into thechilds mouth. Provided by either of these methods the relation ofthe head to the shoulders is such that no twisting of the neck takes. Fig. 224—Base ot skull: M M,bimastoid diameter. TREATMENT OF CONTRACTED PELVES. 501 place, the amount of force that can be employed without producingfatal lesions is often something astounding. Thus, Rokitansky,* ex-perimenting with the bodies of still-born infants, found the utmoststrength put forth by two men upon the trunk was insufficient tocause rupture of the vertebral ligaments and separation of the artic-ulations. It is usual, however, to combine pressure from above,exercised by a skilled assistant upon the head through the abdomi-nal walls, with tractions from below. Schroeder states f that thispractice is coeval with podalic versiou. It was known to Celsus and
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Keywords: ., bookcentury1800, bookdecade1890, bookidsci, booksubjectobstetrics
