A System of midwifery : including the diseases of pregnancy and the puerperal state . ce, and the occiput to the leftsacro-iliac synchondrosis, as shown in Fig. 113. On a digital exami-nation, it is the right Bide of the head which the finger touches. Thesagittal suture, iii reference to the posture of the woman, is traced down-wards and backward- to where it terminates in the posteriorfontanelle,while, in the contrary direction, the linger follows it upwards and for-wards to the anterior fontanelle. The opinion is very generally enter-tained that, in the fourth position, the engagement of the
A System of midwifery : including the diseases of pregnancy and the puerperal state . ce, and the occiput to the leftsacro-iliac synchondrosis, as shown in Fig. 113. On a digital exami-nation, it is the right Bide of the head which the finger touches. Thesagittal suture, iii reference to the posture of the woman, is traced down-wards and backward- to where it terminates in the posteriorfontanelle,while, in the contrary direction, the linger follows it upwards and for-wards to the anterior fontanelle. The opinion is very generally enter-tained that, in the fourth position, the engagement of the head is more difficult, and its rotation slower than in the third. It is impossible to avoid the conclusion that this is due. in a great measure, if aol entirely, 308 MECHANISM OF LABOR. [CHAP to the rectum, which, by encroaching upon the left oblique it less capacious than the right. The fourth position being theconverse of the third as the second is of the first, we find the descrip-tion of the one will serve. nntt<itix mutandis—reading right for left, and. Fourth cranial po so forth—in every respect for the other. It may thus terminate in twoways, according as the occiput or the forehead descends. In the formercase, the occiput passes below the left, and the forehead above the rightischial spine,so th^tthefourth position rotates into the first in the natural and normal course of such a case,and ends with the occiput underthe pubic arch as usual, the rightside of the head thus being, duringthe whole course of the labor, thelowest in the pelvis. In this, asin the third position, a certainnumber of cases terminate withthe forehead under the pubis, themechanism, in each case, being pre-cisely similar, the occiput usuallypassing over the fourchette, where-upon the forehead, nose, and chinsweep successively, backwards anddownwards, from behind the pubicsymphysis. The position of thefoetal head in reference to the out-let of the pelvis is shown in theengrav
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectobstetrics, bookyear1
