Practical midwifery; handbook of treatment . mobility of the foetusis unimpaired at the time of operation. Its performance is rendered more easy by the use of an anaes-thetic, which should be given to full surgical anaesthesia. In this country the patient is usually placed in the lithotomyposition, in which case she should lie across the bed, with thebuttocks well over its edge. Each leg should be held bj an assist-ant, and the oi^erator should sit between them. The full observ- 172 PRACTICAL MIDWIFERY. ance of all possible antiseptic precautions is as nece««sary as in in-ternal version. The e
Practical midwifery; handbook of treatment . mobility of the foetusis unimpaired at the time of operation. Its performance is rendered more easy by the use of an anaes-thetic, which should be given to full surgical anaesthesia. In this country the patient is usually placed in the lithotomyposition, in which case she should lie across the bed, with thebuttocks well over its edge. Each leg should be held bj an assist-ant, and the oi^erator should sit between them. The full observ- 172 PRACTICAL MIDWIFERY. ance of all possible antiseptic precautions is as nece««sary as in in-ternal version. The exact position of the child and its extremities is carefullymade out by abdominal and vaginal examination, and, the rectumand bladder having been emptied, the hand of the same name asthe position is passed into the vagina until two fingers can be in-serted into the os to their full length. The fingers then raise thehead and push it gently to the side toward which the occiput isturned, while the other hand pushes the breech by external ma-. FiG. 32.—First Stage of Bipolar Version (Galabin). nipulation in the opposite direction (Fig. 32). This process iscontinued as long as the head remains within reach of the fingers are then moved toward the breech in search of a knee,which, unless the normal flexion of the child has been lost, is bythis time well within reach (Fig. 33). The knee is distinguished from the elbow by the fact that itpoints toward the head, while the elbow points to the presence of the patella may also be recognized in some cases,and, if found, is of course conclusive. If by cliance a foot bereached before the knee and surely recognized, it should at oncebe seized. The foot is distinguished from the hand by the pres- OBSTETRIC SURGERY. ITS ence of the malleoli and of the prominence of the heel, and by thefact that the great toe is of equal or greater length than the others,and placed in the same plane with them, while the thumb isshorter than
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectmidwifery, bookyear18
