A system of obstetrics . process is so rare that only 10 cases were observed by Reike in twohundred and twenty thousand labors; Busch in 6180 only 2; Spath 5in 15,523; Kuhn 9 in 17,375; and Arneth none in 6608: hence theobstetrician cannot trust to this method of delivery. The complicationwithout the intervention of art at the proper time is a very grave onefor both mother and child; the latter, from the long continuance of thelabor and from the firm contraction of the uterus interfering with theplacental circulation, or from direct pressure upon the cord, perisheswith asphyxia, while the form
A system of obstetrics . process is so rare that only 10 cases were observed by Reike in twohundred and twenty thousand labors; Busch in 6180 only 2; Spath 5in 15,523; Kuhn 9 in 17,375; and Arneth none in 6608: hence theobstetrician cannot trust to this method of delivery. The complicationwithout the intervention of art at the proper time is a very grave onefor both mother and child; the latter, from the long continuance of thelabor and from the firm contraction of the uterus interfering with theplacental circulation, or from direct pressure upon the cord, perisheswith asphyxia, while the former is liable to rupture of the uterus, fol-lowed by dangerous hemorrhage or by septicaemia. The liability torupture of the uterus arises from the continuance of uterine activitystruggling against an invincible obstacle, with consequent thinning ofthe lower uterine segment, in some part of which the tear occurs. The Fig. 289. contraction-ring round ligament _J internal os J — contraction-ring round ligament external os. Shoulder Presentation: Threatened Rupture of the Stretched Lower Segment of the Uterus and Cervix. accompanying illustration, from Schroeder, shows better than words candescribe the condition of the uterus in neglected shoulder presentationand when rupture is imminent. 758 ANOMALIES OF THE FORCES IN LABOR. The general indication in case of a shoulder presentation, so far astreatment is concerned, is to perform version, podalic rather thancephalic being usually selected, though really the latter can in manyinstances be successfully done and with comparative facility, especiallyby the method proposed and practised by the late Dr. M. B. in some cases the very act of version may be the cause of theinjury, or in others the tear has already occurred and the obstetricianreceives the blame, and in still others version is impossible. As longas the membranes are unruptured there is no danger of uterine rupture,and therefore the obstetrician need not be in hast
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectobstetrics, bookyear1
