Cyclopædia of obstetrics and gynecology . Fig. 12.—Position of Hands in Kxtraction. Delivery of the Inferior Extremities. when the nates appear, the foetus is found astriJe of the cord, we musttry to loosen this by passing it over the natis belonging to the undeliveredfoot. If the cord cannot be loosened, then it may be ligated in twoplaces and cut between. Of course, in such event, very rapid extractionis indicated. The breech delivered, ths thumbs are applied over the sacrum, the VERSION. 29 other fingers over the anterior of the pelvis, (Fig. 13,) and traction ismade downwards and slightly
Cyclopædia of obstetrics and gynecology . Fig. 12.—Position of Hands in Kxtraction. Delivery of the Inferior Extremities. when the nates appear, the foetus is found astriJe of the cord, we musttry to loosen this by passing it over the natis belonging to the undeliveredfoot. If the cord cannot be loosened, then it may be ligated in twoplaces and cut between. Of course, in such event, very rapid extractionis indicated. The breech delivered, ths thumbs are applied over the sacrum, the VERSION. 29 other fingers over the anterior of the pelvis, (Fig. 13,) and traction ismade downwards and slightly backwards, until the thorax appears^ Ifthe cord is tense at the navel, it is pulled gently downward, in order toavoid traction on it. If it cannot be disengaged, it must be cut and thefoetal end compressed by an assistant till extraction is completed. Usu-ally, as the body descends the foetus rotates, so that the dorsum looks for-. FiG. 13.—Extraction of the Breech. ward. If this rotation does not occur spontaneously, it must be madeartificially. In order to effect this, while downward traction is beingmade, the foetus is turned in the desired direction, and this is ordinarilyan easy matter. But if the body resists, rather than use force we hadbest desist. Where version is easy and contractions good, the arms remain flexedon the chest; but if the uterus retracts more, the arms extend along the 30 A TREATISE OX OHSTETRICS. head, and must be disengaged. The posterior arm sliould be first ex-tracted, and then the anterior, and there remain^- only the head. The liead may be flexed or extended, the occiput anterior or the uterine contractions are not sufficient, we must extract it rapidly,lest the infant emleaA^or to breathe, and asphyxiate. Since the extractionof the arms and head offers difficulties, we will describe this later on.
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