A textbook of obstetrics . Fig. 253. Presentation I the umbili ABNORMALITIES IN MECHANISM. 93 cent parts—namely, the axilla, the clavicle, the spine of thescapula, the acromion process, the head of the humerus, and theribs. Causes.—The causes of a shoulder presentation may bedivided under three heads : (i) Abnormalities in the shape andposition of the uterus, as a pendulous abdomen ; a uterusbicornis; the broad uterus accompanying a kyphotic spine ;the distorted uterus due to uterine fibroids and other abdominaltumors, and to multiple pregnancy. (2) Conditions preventing. Fig. 254.—Spontaneous
A textbook of obstetrics . Fig. 253. Presentation I the umbili ABNORMALITIES IN MECHANISM. 93 cent parts—namely, the axilla, the clavicle, the spine of thescapula, the acromion process, the head of the humerus, and theribs. Causes.—The causes of a shoulder presentation may bedivided under three heads : (i) Abnormalities in the shape andposition of the uterus, as a pendulous abdomen ; a uterusbicornis; the broad uterus accompanying a kyphotic spine ;the distorted uterus due to uterine fibroids and other abdominaltumors, and to multiple pregnancy. (2) Conditions preventing. Fig. 254.—Spontaneous evolution. engagement of the cephalic or the pelvic extremity of the fetus,as deformities of the pelvis; abnormally large child; monstrosi-ties ; placenta praevia. (3) Abnormal mobility of the fetus, asoccurs in hydramnios, after fetal death, or in premature births. Mechanism.—Strictly speaking, there is no mechanism ofshoulder presentations. The course of these cases is impactionof the shoulder, enormous dilatation of the lower uterine seg-ment, ascension of contraction-ring, destruction ^r. the fetus In-prolonged pressure, and death of the mother by rupture of theuterus or by exhaustion. As a matter of fact, however, nature 394 THE MECHANISM OF LABOR. can, in very exceptional cases, effect delivery by one of threemethods :
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
