The practice of obstetrics, designed for the use of students and practitioners of medicine . ad of the bisacromial (Fig. 620). Theposterior shoulder is thus permitted to be delivered first, contrary to the commoncustom, and should be carefully guided in its / passage over the peri-neum. Shoulder deliveryshould be accomplishedwhenever possible bythe natural forces, sinceI have found that man-ual extraction increasesthe number of perineallacerations. Care shouldbe taken lest during thedelivery of the shoul-ders an existing lacer-ation caused by the headbe increased in the detentionof
The practice of obstetrics, designed for the use of students and practitioners of medicine . ad of the bisacromial (Fig. 620). Theposterior shoulder is thus permitted to be delivered first, contrary to the commoncustom, and should be carefully guided in its / passage over the peri-neum. Shoulder deliveryshould be accomplishedwhenever possible bythe natural forces, sinceI have found that man-ual extraction increasesthe number of perineallacerations. Care shouldbe taken lest during thedelivery of the shoul-ders an existing lacer-ation caused by the headbe increased in the detentionof the anterior shoulder behind the pubis the fetal hand of the opposite arm lyingacross the childs chest will usually soon appear in the vulva. Delivery, we havefound, is assisted by slowly flexing this forearm and arm out through the vulva andthus delivering the posterior shoulder by slight traction on the posterior there be delay in the expulsion of the posterior shoulder, traction upwardupon the head, the fingers encircling the neck, is to be preferred to traction with a \ \. Fig. 626.—Method of Cutting the Umbilical Cord afterTHE Application of the Two Ligatures. THE MANAGEMENT OF LABOR. 487 finger in the axilla. (See Part X.) Should there be delay in the delivery of theanterior shoulder, it is best remedied by making traction directly downward
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
