A manual of obstetrics . antisepsis must be observed to prevent subse-quent infection. (4) Dystocia due to Fetal Accidents.—{a) Funic Pres-entation {Chorda Prcevia, Prolapsus funis, Prolapse of theCord).—This consists in a descent of a loop of the umbilicalcord in advance of the presenting fetal portion (Fig. 142). Varieties. — There are in-cluded under this heading,as described by Herman,three distinct conditions, asfollows: {a) Tiuechordaprce-via, in which from the verybeginning of labor the cordpresents at the superior strait;(/>>) prolapse of the cord, or acarrying downw
A manual of obstetrics . antisepsis must be observed to prevent subse-quent infection. (4) Dystocia due to Fetal Accidents.—{a) Funic Pres-entation {Chorda Prcevia, Prolapsus funis, Prolapse of theCord).—This consists in a descent of a loop of the umbilicalcord in advance of the presenting fetal portion (Fig. 142). Varieties. — There are in-cluded under this heading,as described by Herman,three distinct conditions, asfollows: {a) Tiuechordaprce-via, in which from the verybeginning of labor the cordpresents at the superior strait;(/>>) prolapse of the cord, or acarrying downward of thecord with the gush of theliquor amnii at the time ofthe rupture of the mem-branes; (r) expression of thecord, a condition occurringlate in labor, and signifying a forcing downward of a loopby the side of the presenting fetal head that has alreadybecome engaged. The ultimate result of all these condi-tions is the same; hence they may well be consideredtogether. Frequency.—Funic prolapse occurs about once. Fig. 142.—Prolapse of the cord. FUNIC PRESENTATION. 5OI in from 200 to 300 cases of labor; it is therefore a notvery infrequent complication. Etiology.—The causes of theprolapse may be fetal or maternal. The fetal causes are—id) certain malpositions and malpresentations, as posteriorposition of the occiput; presentation of the trunk, the face,the brow, and the breech ; multiple pregnancy, and complexpresentations ; {B) iinder-size of the fetal head, as in prema-ture labor; («:) anomalies of the fetal appendages, as hy-dramnios; sudden escape of the hquor amnii, especiallywhen the patient is standing; excessive length of the cord;marginal attachments of the cord; placenta prsevia. Thematernal causes are various degrees of contraction of thepelvis, preventing exact coaptation of the presenting part tothe pelvic brim; multiparity (the relaxed abdominal wallspermitting a retraction of the presenting part from the pel-vic inlet); pendulous abdomen ; uterine
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
