A textbook of obstetrics . en the delivery of the head in thefollowing order: Chin, face, forehead, anterior fontanel, sweep-ing successively over the perineum and appearing in the vulvarorifice Prognosis.— The fetal mortality of breech presentations isabout thirty per cent., including badly managed cases in gen- ABNORMALITIES IN MECHANISM. 387 eral practice. There is some added danger of injury to maternalsoft parts, on account of the necessity for rapid and sometimesviolent extraction of the after-coming head. Treatment.—Before Labor external version may be will not always be fo
A textbook of obstetrics . en the delivery of the head in thefollowing order: Chin, face, forehead, anterior fontanel, sweep-ing successively over the perineum and appearing in the vulvarorifice Prognosis.— The fetal mortality of breech presentations isabout thirty per cent., including badly managed cases in gen- ABNORMALITIES IN MECHANISM. 387 eral practice. There is some added danger of injury to maternalsoft parts, on account of the necessity for rapid and sometimesviolent extraction of the after-coming head. Treatment.—Before Labor external version may be will not always be found practicable, and after the fetal bodyhas been turned there is a disposition on the part of the fetus toresume its original position. The application of two long cylin-drical compresses to the sides of the uterus, and a firm abdomi-nal binder, may prevent a return of the breech labor has begun, inaction should be the physicians policyuntil the fetal bodv is born to the umbilicus, unless maternal or. Fig. 243. — Delivery of the after-coming head when it is flexed. fetal life is threatened or an indication for rapid delivery soon as the trunk appears the patient should be placed in thelithotomy position across the bed, and delivery of the shouldersand head should be effected by pressing upon the fundus with onehand, the other hand being inserted in the vagina to favor anteriorrotation of the shoulder, anterior rotation of the occiput, and todirect the passage of the head through the vagina (Wiegandsmethod; see Delivery of the After-coming Head). Abnormalities in Mechanism.— The most frequent and impor-tant anomalies are backward rotation of the occiput and excess- 388 THE MKC1IAXISM OF LABOR. ive rotation of the breech. Backward rotation of the occiputis very exceptional. The mechanism of the delivery of the headin these cases differs as the head remains flexed or becomesextended. When flexed, the chin, face, forehead, and anterior fon-tanel
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
