The practice of obstetrics, designed for the use of students and practitioners of medicine . ng part with the pelvic inlet. Thusmalpresentations, such as shoulder, brow, orface, are causes, since they do not properlyengage at the inlet; or anomalies in the shapeof the uterus which have developed duringpregnancy from some cause or are due totumor, hydramnios, or twins; or displacementdue to a pendulous abdomen. Pelvic contrac-tion, as in the prolapse of the cord, is a com-mon cause, as it prevents a proper adjustmentof the presenting part to the inlet. For thesame reason multiple presentation,
The practice of obstetrics, designed for the use of students and practitioners of medicine . ng part with the pelvic inlet. Thusmalpresentations, such as shoulder, brow, orface, are causes, since they do not properlyengage at the inlet; or anomalies in the shapeof the uterus which have developed duringpregnancy from some cause or are due totumor, hydramnios, or twins; or displacementdue to a pendulous abdomen. Pelvic contrac-tion, as in the prolapse of the cord, is a com-mon cause, as it prevents a proper adjustmentof the presenting part to the inlet. For thesame reason multiple presentation, as in twins,Rupture of the membranes in the sitting orstanding posture, especially in multiparae, and sudden exertion on the part ofthe mother during or even after engagement of the presenting part, must berecognized as etiological factors. Death of the fetus with loss of its musculartonicity must also be included. Diagnosis.—This is a simple matter, and the possibility of this accidentshould always be one of the mental queries at all first and subsequent internalexaminations of OF Fig. 691.—Lateral ObliquityTHE Head in Vertex Presenta TION. and a premature fetus are causes. FETAL DYSTOCIA FROM FAULTY ATTITUDE. 521 Prognosis.—In shoulder and breech presentations prolapse of one or botharms is rather a favorable condition, and affects the prognosis this reason I am never accustomed to replace the prolapsed arm or armsunder such circumstances. The advantage lies in the fact that we can usuallyapply a sling or soft fillet to the arm or arms, keep them prolapsed, and thus thesubsequent danger of the arm or arms becoming extended and causing impactionof the after-coming head is obviated. Prolapse of an arm in vertex presentationis often a serious condition. The arm occupying the inlet with the vertex mayresult in a lateral deviation of the head, and a vertex presentation may thus beconverted into a bregma, brow, or face, or, if the head is freely movabl
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
