A manual of obstetrics . means of pressure in axis of brim (Dickinson). as it emerges from the vulvar orifice the left arm shouldbe elevated, so that the fetal back is directed toward themothers abdomen; this movement prevents undue disten-tion, with laceration, of the perineum. (2) The Mcmriccaiior Vcit-Sincllie Method.—This is the same as the precedingas regards the disposal of the left hand. Instead, however,of indirect pressure upon the fetal head through the abdom-inal wall, the fingers of the right hand are passed into thevagina above the child, the middle finger extending up the 1/6 A M
A manual of obstetrics . means of pressure in axis of brim (Dickinson). as it emerges from the vulvar orifice the left arm shouldbe elevated, so that the fetal back is directed toward themothers abdomen; this movement prevents undue disten-tion, with laceration, of the perineum. (2) The Mcmriccaiior Vcit-Sincllie Method.—This is the same as the precedingas regards the disposal of the left hand. Instead, however,of indirect pressure upon the fetal head through the abdom-inal wall, the fingers of the right hand are passed into thevagina above the child, the middle finger extending up the 1/6 A MANUAL OF OBSTETRICS. neck until the external occipital protuberance is felt, uponwhich direct pressure is exerted; the index and ring fingersgrasp the clavicles, and traction is made by both handsdownward, outward, and upward, following the course of theparturient canal. If it be desired, an assistant may aid inthis movement by suprapubic pressure upon the descend-ing head. (3) The Prague Method (Fig. 80), also called. Fig. 80.—Prague method of extracting the after-coming head, superior strait (Dickinson). PiigJis Method.—The right hand firmly grasps the childsankles, the heels fitting into the palm of the hand, the mid-dle finger just above the internal malleoli, and the indexand ring fingers above the external malleoli; the indexfinger of the left hand is then passed over the right claviclefrom above, and the remaining fingers of this hand over theleft clavicle, and combined traction with the two hands ismade downward and outward until the head well distendsthe perineum; the right hand now grasps the legs justbelow the knees in the same manner as before, the toes,however, resting upon the back of the hand; with thishand the body is forcibly lifted upward and carried overthe mothers abdomen, toward which the back of the childis directed, while the left hand remains firmly fixed at thesymphysis as a fulcrum beneath which the head rotateson its outward way over the perineu
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
