. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. n is not much used inhead presentations, because podalic version is now gen-erally followed by immediate extraction, and thereforepresupposes a degree of dilatation which admits of theintroduction of the entire hand, but it is of value in somecases of placenta praevia in which there is profuse flow-ing at an early stage of labor. In such cases it is useful,both because it can usually be completed with less lossof time than is consumed in the preparation of the os
. A Reference handbook of the medical sciences : embracing the entire range of scientific and practical medicine and allied science. n is not much used inhead presentations, because podalic version is now gen-erally followed by immediate extraction, and thereforepresupposes a degree of dilatation which admits of theintroduction of the entire hand, but it is of value in somecases of placenta praevia in which there is profuse flow-ing at an early stage of labor. In such cases it is useful,both because it can usually be completed with less lossof time than is consumed in the preparation of the os forinternal version, and because, after its completion, thepressure of the half-breech against the os is usually suffi-cient to control the hemorrhage until full dilatation hasbeen accomplished. It may, however, be used in anycase in which the mobility of the foetus is unimpaired atthe time of operation. Its performance is rendered more easy by the use ofan anaesthetic, which should be given to full surgicalanaesthesia. In this country the patient is usually placed in thelithotomy position, in which case she should lie across. Fig. 4559.—First Stage ot Bipolar Version. (Galabin.) the bed, with the buttocks well over its edge. Each legshould be held by an assistant, and the operator shouldsit between them. The full observance of all possibleantiseptic precautions is as necessary as in internal ver-sion. The exact position of the child and its extremities iscarefully made out by abdominal and vaginal examina-tion, and, the rectum and bladder having been emptied,the hand of the same name as the position is passed intothe vagina until two fingers can be inserted into the osto their full length. The fingers then raise the head andpush it gently to the side toward which the occiput isturned, while the other hand pushes the breech by externalmanipulation in the opposite direction (Fig. 4559). Thisprocess is continued as long as the head remains withinreach of the hand. The fingers
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectmedicine, bookyear188
