The Cleveland medical journal . of the use of the forceps on a head whichfails to enter the pelvic brim under the influence of good only is this true, but because of the delay and manipulationincident to the use of forceps we greatly diminish the advisabilityand safety of two of our elective procedures, viz., version andCesarean section. Pubiotomy remains practically our only alter-native under these circumstances, and even this procedure is 124 The Cleveland Medical Journal desirable only if the forceps attempt was made with hospitalsurroundings for aseptic work. By the time forceps
The Cleveland medical journal . of the use of the forceps on a head whichfails to enter the pelvic brim under the influence of good only is this true, but because of the delay and manipulationincident to the use of forceps we greatly diminish the advisabilityand safety of two of our elective procedures, viz., version andCesarean section. Pubiotomy remains practically our only alter-native under these circumstances, and even this procedure is 124 The Cleveland Medical Journal desirable only if the forceps attempt was made with hospitalsurroundings for aseptic work. By the time forceps has been tried and proven unsuccess-ful, the lower uterine segment is usually so thinned out and con-tracted about the child as to make uterine rupture a very realrisk of version. The considerable length of labor, the elapsedtime after rupture of the membranes, and the manipulationswhich have been made, all contribute their share toward making SHOW*/ ZSyJLEJtiGprt Of Llfillz, SpVpON. sjxjrofiJ, •spr/rowL 3J24pO/J_ spzyiofJi. Sp4/yOA/ N^^-o/pct/ss- i/opjs/bSized Diagram III Cesarean section a procedure of great danger to the mother andof doubtful value to the child after an attempt at forceps. Within the past year I have had two cases illustrative of theserious risk of maternal damage involved in forceps applicationat station I. Mrs. X. Primipara, in the care of a midwife, who called aphysician because of lack of progress of the labor. The doctor Ske£l—Station in Labor 125 applied the forceps but failed to deliver. On examination at thehospital, I found the patient bleeding freely; pulse 160 andweak; the fetal heart not audible. Examination under anesthesiarevealed a contracted pelvis, the head above the brim, and a per-foration of the vaginal vault through which the hand could bepassed freely into the abdominal cavity. The child was deliveredby cranioclasis and the vaginal rupture packed. The motherrecovered after a rather slow convalescence. SpZJTOfsL spijroA/. sp^fioiJ.
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectmedicine, bookyear191
