. An American text-book of obstetrics. For practitioners and students. per cent. Head and breech Both pelvic presentations Head and transverse Breech and transverse Both transverse 35 It may be noted that a transverse position is found in per cent, of difficulties in labor are frequent, the uterine muscle is usuallyweakened by overstretching, and there may be trouble in the third stage oflabor in the delivery of the placenta. Some form of operative interference isdemanded in about 25 per cent, of all cases. In the majority of cases (79 per cent.) the
. An American text-book of obstetrics. For practitioners and students. per cent. Head and breech Both pelvic presentations Head and transverse Breech and transverse Both transverse 35 It may be noted that a transverse position is found in per cent, of difficulties in labor are frequent, the uterine muscle is usuallyweakened by overstretching, and there may be trouble in the third stage oflabor in the delivery of the placenta. Some form of operative interference isdemanded in about 25 per cent, of all cases. In the majority of cases (79 per cent.) the interval between the delivery oftwins is less than an hour. A longer delay than this indicates the likelihoodof some obstruction to the birth of the second infant or a failure of expulsiveforces. Serious difficulty in twin labors may arise in one of three ways: Both 568 AMERICAN TEXT-BOOK OF OBSTETRICS. heads present at once, one a little in advance of the other, the second impacted inthe neck of the first (Fig. 377); the first child descends by the breech, and the. Fig. 377.—Impaction of heads in twin labor. Fig. 378.—Locking of heads in twin labor. head of the second child is caught by the chin of the first and pushed into thepelvis (Fig. 378); one child sits astride of the other, which is transverse. If bothchildren should be found attempting to engage by the head in the superior strait at one time, one child should be retardedwhile the other is artificially extracted. If this isimpossible, the first head should be extracted byforceps, the second be treated in like manner, andthen the trunks should be delivered one after theother. Embryotomy is a last resort, but is scarcelyever necessary. A coiling of the cords (Fig. 379) and their en-tanglement may be a source of difficulty and delayin unioval twins. It may be necessary to cut oneor both cords between ligatures before the childrencan be delivered. In case one child presents by the head and theother by the feet, both m
Size: 2274px × 1099px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
