A manual of practical obstetrics . Breech presentation—legs extended. Each of these may again be subdivided as follows: g. Delivery of the shoulders. a. Moulding, b. Descent, c. Rotation, and d. Delivery of the breech. e. Descent, /. Rotation, and h. Flexion, i. Descent, j. Rotation, and /-. Delivery of the head. Mechanism in Left Sacro-anterior Position (Sacrumto Left Acetabulum).—Here the longest diameter of the LEFT SACRO-ANTERIOR POSITION 209 breech, viz., from one trochanter to the other, occupies thatoblique diameter of the brim which extends from the rightacetabulum to the left sacroili
A manual of practical obstetrics . Breech presentation—legs extended. Each of these may again be subdivided as follows: g. Delivery of the shoulders. a. Moulding, b. Descent, c. Rotation, and d. Delivery of the breech. e. Descent, /. Rotation, and h. Flexion, i. Descent, j. Rotation, and /-. Delivery of the head. Mechanism in Left Sacro-anterior Position (Sacrumto Left Acetabulum).—Here the longest diameter of the LEFT SACRO-ANTERIOR POSITION 209 breech, viz., from one trochanter to the other, occupies thatoblique diameter of the brim which extends from the rightacetabulum to the left sacroiliac synchondrosis. The sacrumof the child being directed toward the left acetabulum, itsback, and, of course, the back of its head (occiput), are directedtoward the left anterior part of the uterus, in a line with theleft acetabulum ; hence, when the body is delivered, the occiputof the after-coming head will also be directed to the left acetabu-lum. As labor progresses there occur: Fig. pr Rotation and delivery of hips. This figure represents the legs extended,which is unusual. 1. Moulding of the breech, by which it simply. becomesgradually compressed (moulded) into a circular shape, sothat it may pass through the os uteri and pelvic brim. 2. Descent—the breech passing down the pelvic cavity tothe pelvic floor. 3. Rotation.—The left hip (the hip nearest the pubes) glidesalong the right anterior inclined plane to the pubic symphy-sis ; while the right hip (the hip nearest the sacrum) glides 210 BREECH along the left posterior inclined plane to the sacrum. The long(bi-trochanteric) diameter of the breech, which entered thebrim in the oblique pelvic diameter, has now, therefore, be-come parallel with the longest (antero-posterior) diameter ofthe inferior strait. (See Fig. 76, page 209.) 4. Delivery of the breech—the hip that is toward the pubesfixing itself against the arch, while the other one sweeps roundthe curve of the (maternal) sacrum and comes out first at
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