Practical midwifery; handbook of treatment . e notch, and filled only withsoft and yielding tissue. The occiput being exposed to an excessof pressure on its posterior surface, and the sinciput to an excessof pressure anteriorly, the result is rotation; but it must be notedthat this is dependent upon flexion, since if flexion is lost, and 9G PRACTICAL MIDWIFERY. the sinciput and occiput occupy a[)i)roxiuiately the .same planeof the pelvis, l)otli are to an excess of pressure up(jii thesame side, and there is nothing to produce rotation. When these forces have brought about rotation, th
Practical midwifery; handbook of treatment . e notch, and filled only withsoft and yielding tissue. The occiput being exposed to an excessof pressure on its posterior surface, and the sinciput to an excessof pressure anteriorly, the result is rotation; but it must be notedthat this is dependent upon flexion, since if flexion is lost, and 9G PRACTICAL MIDWIFERY. the sinciput and occiput occupy a[)i)roxiuiately the .same planeof the pelvis, l)otli are to an excess of pressure up(jii thesame side, and there is nothing to produce rotation. When these forces have brought about rotation, the occiputsinks into a lower position in the pelvis, and enters the gutterformed by the lower part of the sacrum and the muscles of thepelvic diaphragm (Fig. 10); it is then held in its anterior positionby the lateral pressure of the ischial-tuberosities, and further ro-tation is therefore impossible; and since the head as a whole liesagainst the shelving surface of the sacrum, coccyx, and perinajum,^the movement of expulsion at once / (I Fig. 10.—Diagram of the Stage of Expulsion, a, Curvfi of Carus, Expulsion.—The occiput is now free from all but lateral pres-sure, but the frontal end of the head still rests at the bottomof a gutter formed by the shelving posterior wall, and as thechild is pressed down from above by the uterine contractions,the sinciput is in its turn driven forward, forcing the occiput be-fore it. The motion of the head during ths stage is directly for-ward until the oceii^ital protuberance es^^apes from under theedge of the symphysis, when the occipital end being entirely freedfrom pressure, and the neck arrested by the pubic arch, the con-tinued forward motion of the frontal end of the head, which per-sists under the influence of the iutra-uterine forces, results in amovement of extension of the head upon the trunk, by whichthe forehead, face, and chin are successively swept over thefourchette and Ijrought into the world. This movement of ex-te
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectmidwifery, bookyear18
