. A system of obstetrics . generally easier to reach than the ante-rior, and is therefore usually brought down first. To accomplish thisthe bodv of the child is carried well up to the front around the sym-physis pubis; the posterior shoulder is thereby brought within reachand more room afforded for manipulation. Two fingers are passedalong the side and back of the child up over its posterior shoulder, tillthey can be hooked over the humerus; the arm is then easily carriedwith them across the face and the forearm drawn down over the breast(Fig. 91). If this manoeuvre fails, the operator may wit
. A system of obstetrics . generally easier to reach than the ante-rior, and is therefore usually brought down first. To accomplish thisthe bodv of the child is carried well up to the front around the sym-physis pubis; the posterior shoulder is thereby brought within reachand more room afforded for manipulation. Two fingers are passedalong the side and back of the child up over its posterior shoulder, tillthey can be hooked over the humerus; the arm is then easily carriedwith them across the face and the forearm drawn down over the breast(Fig. 91). If this manoeuvre fails, the operator may withdraw hishand, and, passing the other one along the childs abdomen, attempt tobend the posterior elbow toward the anterior pelvic wall. The poste-rior arm having been delivered, the childs body is carried well backover the perineum and the anterior arm released by a similar manoeuvre(Fig. 92). If there is not room enough to deliver the anterior armbeneath the symphysis, the liberated arm should be seized and drawn Fig. Method i Liberating the Anterior Ann Bai • up toward the symphysis: tin- anterior arm will then probably rotato backward into the hollow of the -an tun. 1 I the childs back point- n the left, the free arm should be raised along the lefl labium ; it t th<right, along the right. The second arm may ? then delivered in tin Bame wav a- the first. 236 VERSION. The following manoeuvre sometimes sueeeeds when others fail: graspthe childs body above the hips and rotate it upon its long axis till theback is brought a little to the left; the pubic arm, not being able to fol-low the rotation of the trunk, is thrown somewhat across the chest,where it can be more easily reached ; then rotate the body as much in theopposite direction in order to bring the sacral arm within reach : onlygentle manipulation is permissible; violent rotation may twist thechilds neck. Occasionally the anterior arm is displaced backward(nuchal or dorsal displacement) and the forearm thrown a
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectobstetrics, bookyear1
