A textbook of obstetrics . t tosecure flexion, as in Schat/.s method of treating a face pres-entation. If this plan (ail, the hand may be inserted into the ABNORMALITIES IN MECHANISM. 379 vagina and uterus to pull the occiput down. Should thisattempt not succeed, it would be best to convert the brow into aface presentation if the chin is anterior. Failing in this, versionshould be tried if the waters are not drained off or if the present-ing part is not fixed in the superior strait. If the chin is anteriorand the presenting part is firmly fixed in the pelvis, the appli-cation of the forceps us
A textbook of obstetrics . t tosecure flexion, as in Schat/.s method of treating a face pres-entation. If this plan (ail, the hand may be inserted into the ABNORMALITIES IN MECHANISM. 379 vagina and uterus to pull the occiput down. Should thisattempt not succeed, it would be best to convert the brow into aface presentation if the chin is anterior. Failing in this, versionshould be tried if the waters are not drained off or if the present-ing part is not fixed in the superior strait. If the chin is anteriorand the presenting part is firmly fixed in the pelvis, the appli-cation of the forceps usually succeeds ; if the chin is posterior,and if conversion into a vertex presentation, performance ofversion and rotation are all impossible, craniotomy is face and brow presentations with the chin posterior, it is acardinal rule not to use forceps except as rotators ; if traction isresorted to at all, even in mento-anterior positions, it should beemployed with the greatest caution and gentleness. Very rarely. Fig. 232.—Presentation of the greater fontanel. the head may be brought down far enough to meet with resist-ance, and thus be rotated anteriorly ; but unless the head yieldsto moderate traction, embryotomy is preferable. Presentation of the Greater Fontanel.—The head in thisvery rare presentation is set squarely upon the shoulders in asort of military attitude of attention, turned upside down. Inits clinical features this presentation resembles that of a descent of the head is difficult and tedious ; the anterior(frontal) portion rotates forward, but with great difficulty, andserious injury to the maternal soft parts is almost unavoid-able. The stretching of the vaginal walls is so great thatthe perineum may be lacerated into the rectum before the headhas fairly impinged upon the pelvic floor. 3 So THE MECHANISM OF LABOR, Treatment—The abnormal position of the head should bealtered into a vertex presentation by pulling down the occiputwith the
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
