Cyclopædia of obstetrics and gynecology . er the pivot, an as-sistant pulls by this strongly downward, while the operator makes tractionwith one hand at the lock, the other holding the handles. Couzot (de Dinan) presses downward with his knee at the lock, whilethe hands simply control the handles. Chailly knelt before the bed, placedthe handles under his shoulder, the two hands at the lock, and pulleddownwards with all his might. Above all these manoeuvres, more or less violent, we much prefer that THE FORCEPS. 115 of Pajot, (See Fig. 94.) Seize the instrument firmly near the vulva,carry the h
Cyclopædia of obstetrics and gynecology . er the pivot, an as-sistant pulls by this strongly downward, while the operator makes tractionwith one hand at the lock, the other holding the handles. Couzot (de Dinan) presses downward with his knee at the lock, whilethe hands simply control the handles. Chailly knelt before the bed, placedthe handles under his shoulder, the two hands at the lock, and pulleddownwards with all his might. Above all these manoeuvres, more or less violent, we much prefer that THE FORCEPS. 115 of Pajot, (See Fig. 94.) Seize the instrument firmly near the vulva,carry the handles with the other hand at first downward and a little out-ward; then, as the head descends more and more, the hand near the vulvaendeavors to depress the blades. Finally, when the head reaches the peri-neum, depress the handles so as to extend the head, (Fig. 97.) Theforehead thus comes behind the symphysis, as the occiput descends alongthe posterior vaginal wall. Pajots method is certainly less violent than the others, but the deliv. Fig. Delivery op the Occipxt Posterior. ery of the occiput posterior necessarily entails laceration of the perineum,to say nothing of the fact that the head, in passing along the posterior wallof the pelvis, greatly jdistends it, and exposes it to bruising, which may beof great consequence. Finally the blades may slip, if the head does notdescend, or only with difficulty. Hence, as soon as the head reaches thebottom of the cavity, we proceed no further with Pajots method, butendeavor to rotate artificially. We only deliver the occiput posteriorly 116 A TREATISE OX OBSTETRICS. Avhen we are forced to do so, that is to say, when wo cannot rotate withthe forceps. Often this is possible, but tlien again not at all so, and thentiie etforts we make may damage the mother as well as the infant, andwe must extract the occiput posterior, even if we do tear the perineum;and this we can limit by lateral incisions. The method which consists in bringing the
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