. The science and art of midwifery . is roomy, andthe soft parts are devoid, of rigidity. In artificial extraction of thehead, it is proper to bear in mind and to imitate the natural order inexpulsion. In presentations of the foot and knee, the breech, if of small size,may pass the vulva in an oblique or transverse diameter, rotation fol-lowing later during the passage of the trunk. Excessive rotation is not uncommon, both head and trunk some-time describing a half-circle. This occurrence is most frequentlyobserved in cases where the posterior extremity presents, while theanterior buttock is c
. The science and art of midwifery . is roomy, andthe soft parts are devoid, of rigidity. In artificial extraction of thehead, it is proper to bear in mind and to imitate the natural order inexpulsion. In presentations of the foot and knee, the breech, if of small size,may pass the vulva in an oblique or transverse diameter, rotation fol-lowing later during the passage of the trunk. Excessive rotation is not uncommon, both head and trunk some-time describing a half-circle. This occurrence is most frequentlyobserved in cases where the posterior extremity presents, while theanterior buttock is caught above the pubic wall, the prolapsed limbthen rotating, as a rule, to the front.* The Configuration of the Foetus in Breech Deliveries.—During the descent of the child through the genital Canal, more or less swelling isdeveloped upon that portion of the presenting part which is subjected to diminished pressure. This swelling vanes, according to the dura-* Vide KCstneb, Die Steiss- and Fasslagen, p. 21. MECHANISM OF LABOR. 203. Fig. 121.—Showing shape of head in breech presentations.(Budin.) tion of labor, from a slight oedema to a large, intensely discolored tumor. It is usually seated upon the anterior buttock, but often inyad< genital organs, especially the scrotum, which at birth may presenl abluish-black color, and beof double the usual extremities, whennear the breech, may alsoshow signs of discolor-ation. The head has usuallya characteristic roundshape. This is due, ac-cording to Spiegelberg,*to the pressure exertedby the genital canal uponthe circumference of thehead, while at the sametime, with the absence ofpressure fromabove, thereis produced an increasein the convexity of the cranial vault. Two cases reported by in which the lengthof the occiput was comparable to that found in face presentations,show, however, that the original shape of the head counts for some-thing in the appearances presented after delivery. Prognosis.—As regards th
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