Operative midwifery : a guide to the difficulties and complications of midwifery practice . Fig. 11. The Delivery of the After-coming Head (Wigand-Martin Method). Nagel finger into the mouth. The head should be grasped in the ordinaryway employed for delivering the after-coming head. The head isthen pushed up a little and the occiput rotated forwards. If sue]) amanoeuvre is carried out, the head and trunk must be rotated to-gether ; there must be no attempt made to bring about the rotation BREECH PRESENTATIONS 77 of the bead by simply turning the trunk, for that may readily lead tofracture of
Operative midwifery : a guide to the difficulties and complications of midwifery practice . Fig. 11. The Delivery of the After-coming Head (Wigand-Martin Method). Nagel finger into the mouth. The head should be grasped in the ordinaryway employed for delivering the after-coming head. The head isthen pushed up a little and the occiput rotated forwards. If sue]) amanoeuvre is carried out, the head and trunk must be rotated to-gether ; there must be no attempt made to bring about the rotation BREECH PRESENTATIONS 77 of the bead by simply turning the trunk, for that may readily lead tofracture of the upper part of the spine. As stated before, I do notfavour such a device as trying to bring about rotation by pulling orpushing on one arm. In some cases rotation is impossible, either because the head is-. FlG. 45.—The Delivery of the After-coming Head when the Occiput is Posterior J (Prague Method). too firmly fixed in the pelvis, or because the chin has become caughtabove the symphysis pubis. If the chin is down, one may try theordinary method of passing a finger into the mouth and grasping theshoulders with two fingers of the other hand. The child is now 7s OPERATIVE MIDWIFERY pulled backwards, and then, when the forehead is fixed against theposterior surface of the symphysis pubis, the trunk is pulled upwardson to the abdomen of the mother. In such cases, forceps and a deepincision laterally into the perineum will, I believe, give the child thebest chance. In cases in which the chin slips up, and which will some-times require to be terminated by craniotomy, one should attempt to;deliver the head by the Prague rnanuuvre (Fig. 45). Nagel describesa most interesting case where a woman delivered herself by pullingthe childs limbs up on to her abdomen, as indicated in the illustra-tion
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Keywords: ., bookcentury1900, bookdecade1910, bookpubli, booksubjectobstetrics
