A textbook of obstetrics . he fetal back, and, to confirm this fact, the extremities are felt for bya rubbing motion with one outstretched hand on the opposite 3D- THE MECHANISM OF LABOR. side. They arc felt as cylindrical, irregular bodies, slipping awayfrom the hand, and changing their position from time to time. Having located the back and the extremities, the portion of thefeted ellipse presenting at the superior strait is next ascertained. The examiner now faces the womans feet, and, with the out-stretched hands, the fingers parallel with and the middle fingerover the center of Pouparts l
A textbook of obstetrics . he fetal back, and, to confirm this fact, the extremities are felt for bya rubbing motion with one outstretched hand on the opposite 3D- THE MECHANISM OF LABOR. side. They arc felt as cylindrical, irregular bodies, slipping awayfrom the hand, and changing their position from time to time. Having located the back and the extremities, the portion of thefeted ellipse presenting at the superior strait is next ascertained. The examiner now faces the womans feet, and, with the out-stretched hands, the fingers parallel with and the middle fingerover the center of Pouparts ligament, on either side, the fingersdip down beneath the ligament into the pelvic cavity. If thehead is presenting, it is felt as a hard, regular, round body,the greater mass of the occiput, the sharp point of the chin,and the groove between occiput and back being often distin-guishable. At the same time, the density of the head, its com-pressibility, its approximate size, and its relative size to thepelvis may be Fig. 204.—Abdominal palpation : locating the fetal head. By auscultation the fetal heart-sounds are located, and theirrate and intensity are noted. The uterine bruit and the funicsouffle are often heard. The position on the abdomen at whichthe fetal heart-sounds are heard with greatest intensity is ^\diagnostic value in confirming the find, by abdominal palpation,as to position and presentation. By vaginal examination the finger detects the varying por-tions of the fetal body which may present at the superior strait,.is the cranium, the face, the shoulder, the buttocks, the knees,feet, and, exceptionally, the elbow or hand. The position of the Ictus in Utero is longitudinal in 99*j per(cut. of all cases. The cephalic extremity presents in about95,- Per Cent., 95 per cent, being vertex presentations. Inabout one-half of I per cent, of cases the fact- presents; thebrow very rarely. In about 3 per cent, of all casts the breech
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
