The practice of obstetrics, designed for the use of students and practitioners of medicine . rtshilfe, second edition, 1S98, p. 50S. 986 OBSTETRIC SURGERY. delay also endangers the fetus by compression of the cord, placenta, head, orchest. The said anomalies of labor which produce these effects in the motherand child are equivalent to dystocia, maternal or fetal. AVhile it is seldomdifficult to recognize the presence of maternal conditions which demand forcepsintervention, it is by no means always easy to determine when the fetus is inperil. If the heart-beat either increases or diminishes ste
The practice of obstetrics, designed for the use of students and practitioners of medicine . rtshilfe, second edition, 1S98, p. 50S. 986 OBSTETRIC SURGERY. delay also endangers the fetus by compression of the cord, placenta, head, orchest. The said anomalies of labor which produce these effects in the motherand child are equivalent to dystocia, maternal or fetal. AVhile it is seldomdifficult to recognize the presence of maternal conditions which demand forcepsintervention, it is by no means always easy to determine when the fetus is inperil. If the heart-beat either increases or diminishes steadily, evidence is therebyfurnished of disturbance of the placental circulation, which means peril for thechild. This behavior of the heart must not be confounded with the slightvariations w^hich occur during a uterine contraction. The presence of meconiumin the amniotic fluid is dubitable evidence of fetal distress. In breech presen-tations it means nothing at all, for it is expressed from the anus mechanically;and even in head presentations its presence may be inconclusive. I have fre-. FiG. 1205.—Classification of Forceps Operations. High Operation. MedianOperation with Complete Retraction of the Cervix over the Presenting Operation with only Partial Retraction of the Cervix over the Pre-senting Part. Low Operation. quently seen healthy, unasphyxiated children bom by the vertex after a copiousescape of meconium. (Compare Asphyxia, Part IX.) As other evidence ofthe fetal state is not forthcoming, we must place our sole reliance on the fetalheart. Special Indications.—Maternal exhaustion and fetal asphxyia are the generalindications for forceps, but it is necessary to recapitulate the different forms ofdystocia which tend to produce these conditions. The indications may proceedfrom anomalies of the expulsive functions, anomalies of resistance, certainpresentations and positions of the child, and miscellaneous or non-mechanicalcomplications of labor, (i) Anomali
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
