. A treatise on obstetrics for students and practitioners . d into the pelvic cavity. If the patients condition demandit, the forceps must be applied before the hand is removed and laborended. (Plate VIII.) If this effort be unsuccessful, an effort may be made to convert thepresentation into one of the face. To accomplish this the oppositemanoeuvre must be executed. The vertex must be pushed upward andthe chin allowed to descend. By rotating the chin toward the frontand stimulating labor-pains the patients delivery may in some casesbe effected. In flat pelves, if the head can be dislodged, pod
. A treatise on obstetrics for students and practitioners . d into the pelvic cavity. If the patients condition demandit, the forceps must be applied before the hand is removed and laborended. (Plate VIII.) If this effort be unsuccessful, an effort may be made to convert thepresentation into one of the face. To accomplish this the oppositemanoeuvre must be executed. The vertex must be pushed upward andthe chin allowed to descend. By rotating the chin toward the frontand stimulating labor-pains the patients delivery may in some casesbe effected. In flat pelves, if the head can be dislodged, podalic version may beperformed. This, however, will not be possible unless the uterus isrelaxed and danger of uterine rupture be absent. For this procedurethe use of chloroform is indicated. If the child be dead when thephysician sees the case, and the uterus be firmly contracted upon thefoetus, no hesitation must be felt in doing craniotomy. After open-ing and washing out the head delivery should be effected by the cranio-clast. PLATE VIII. FIG. i. FIG. Head and Spinal Column of Foetus, in Flexion and Extension. (Kaltenbach.) ABNORMAL LABOR. 211 In cases of contracted pelves, with parietal presentation of the foetus,where pelvimetry, on examination, shows that labor is impossible inthe normal way, if the child be living and strong, symphysiotomy orabdominal section should be performed. Presentations of the parietal bones are of significance as indicatingprobable pelvic contraction or an abnormal condition of the childsskull. They call for a critical examination of the case and a wisechoice of treatment. Probably the greatest error which can be madein these cases is the indiscriminate application of forceps and the effortto direct the head into the pelvis by forceps without further preparation. It is very easy to err in a diagnosis of foetal engagement in thepelvis in presentations of a parietal bone, or for the inexperienced incases of normal labor. If the pelvic floor be su
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
