. The science and art of midwifery . ry to diagnose the position the headhad occupied within the pelvic canal.* A voluminous scalp-tumor is, as a rule, the result of compressionfrom the bony canal, and forms, therefore, in normal pelves, belowthe narrowing of the inferior strait. In generally contracted pelves,however, where the resistance of the bony canal is encountered at the * The tumor forms, in left occipito-anterior positions, upon the superior posteriorangle of the righl parietal bone, encroaching somewhat upon the small fontanelleand the occiput; in right occipito-anterior positions,
. The science and art of midwifery . ry to diagnose the position the headhad occupied within the pelvic canal.* A voluminous scalp-tumor is, as a rule, the result of compressionfrom the bony canal, and forms, therefore, in normal pelves, belowthe narrowing of the inferior strait. In generally contracted pelves,however, where the resistance of the bony canal is encountered at the * The tumor forms, in left occipito-anterior positions, upon the superior posteriorangle of the righl parietal bone, encroaching somewhat upon the small fontanelleand the occiput; in right occipito-anterior positions, upon the correspondingpoint on the left side of the cranium, [n occipito-posterior deliveries the tumordevelops upon the anterior superior angle of the parietal hone turned to thepubic arch, and encroaching upon the large fontanelle, and even upon the frontalsuture. If the head-rotation i^ complete, and the head i>ulcperiod at the vulva, the tumor may occupy the median line, ami thus obscure Fig. 104.—Showing shape ofhead in occipito-posteriordeliveries. (.Tarnier et Chan-treuil.) L82 LABOR brim, the formation of an enormous scalp-tumor may precede the en-trance of the head into the pelvis. According to Dessaut,* the scalp-tumor is usually of larger sizewhen situated upon the anterior surface of the head, partly because ofthe greater laxity of the tissues, and partly because of the Longer dura-tion of labor when the forehead is directed to the front. Its lengthmay vary from a half-inch to two inches or more. In extreme cases,where the labor has been prolonged, there is sometimes found, asso-ciated with the scalp-tumor, a separation of both the periosteum andthe dura mater from the underlying segment of the cranium. Diagnosis.—The diagnosis of cranial presentations by external pal-pation is usually not difficult. The head is recognized by its hardness,
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Keywords: ., bookcentury1800, bookdec, booksubjectobstetrics, booksubjectwomen
