Obstetrics : the science and the art . its the appearanceafter the rotation has taken place. But after the hips are fullydelivered, they recover the obliquity oftheir former situation, and the bodycontinues to descend so, until the shoul-ders, entering into the pelvis in anoblique direction, come to rotate as didthe hips; the left shoulder advancingto the pubis, as the hip did, and theright one falling back into the hollowof the sacrum. In Fig. 86, the rightshoulder has come to the pubis and theleft to the sacrum. When the shouldersdo not come down well, a finger shouldbe passed up so far as t
Obstetrics : the science and the art . its the appearanceafter the rotation has taken place. But after the hips are fullydelivered, they recover the obliquity oftheir former situation, and the bodycontinues to descend so, until the shoul-ders, entering into the pelvis in anoblique direction, come to rotate as didthe hips; the left shoulder advancingto the pubis, as the hip did, and theright one falling back into the hollowof the sacrum. In Fig. 86, the rightshoulder has come to the pubis and theleft to the sacrum. When the shouldersdo not come down well, a finger shouldbe passed up so far as to reach abovethe one that is nearest, to depress it bydrawing it downwards with the finger,which commonly suffices to cause the arm to escape. Bat if the armdoes not descend readily, let the linger be slid along its upper surfaceto a spot as near as may be to the bend of the elbow, and then the elbowmay be drawn downwards with considerable force, and without anydanger of fracturing the os humeri. One arm having escaped, there Fig. 404 PELVIC PRESENTATIONS. will be little difficulty or delay in getting the other down, especiallyif care be taken to move the body, rotating it in a line of directionopposite to or away from that part where the arm is detained. As soon as the arms are delivered, an examination should be madein order to learn how the head is situated. If the face is found in thehollow of the sacrum, and the chin well down towards the fourchette,it is well. The childs body ought now to be raised upwards on thepractitioners arm, to a height sufficient to enable the longest axis ofthe head to become parallel with the axis of the vagina, and the patientshould be urgently exhorted to bear down and force the childs headout of the passage; for at this time the head is not in the womb, butin the vagina, and for its expulsion there is required rather the effortof the abdominal muscles than that of the uterus, which doubtless does,in many instances, partially close its ori
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Keywords: ., boo, bookcentury1800, booksubjectmidwifery, booksubjectobstetrics
