The practice of obstetrics, designed for the use of students and practitioners of medicine . osture during the firstas well as the second stage. 2. Curative Treatment.—If the child is dead, the presentation or prolapseof the cord does not, of course, constitute a special indication, for the interestsof the mother do not require that the fetus shall be extracted at once. In the curative treatment of presentation of the funis before dilatation of thecervix has taken place, or rupture of the membranes, active interference is not in-dicated. Every effort should be made to prevent the premature rup
The practice of obstetrics, designed for the use of students and practitioners of medicine . osture during the firstas well as the second stage. 2. Curative Treatment.—If the child is dead, the presentation or prolapseof the cord does not, of course, constitute a special indication, for the interestsof the mother do not require that the fetus shall be extracted at once. In the curative treatment of presentation of the funis before dilatation of thecervix has taken place, or rupture of the membranes, active interference is not in-dicated. Every effort should be made to prevent the premature rupture of themembranes. For this purpose a Barnes bag may be introduced, or the vagina maybe tamponed. The patient should be cautioned against straining, and shouldassume the exaggerated latero-prone position (Part X) on the side opposite to thaton which the cord lies, in order that gravity may favor the return of the displacedcord. The knee-chest position is also frequently useful in causing the return ofthe cord. If the fetal heart-sounds begin to fail, the cord should be pushed up be-. FiG. 701.—Prolapse of the Cord in aDoubled Fetus, the Anterior FetalPlane Presenting. 526 PATHOLOGICAL LABOR. tween the pains, care being taken not to rupture the membranes. This should bedone while the patient is in the knee-chest position. If the cord does not return,the membranes should be ruptured, and sufficient descent of the head secured toretain the cord, by expression of the fetus or by using forceps. After the cordhas been replaced, the patient should lie upon the side, as above described, andwith the hips elevated by a pillow. If the accoucheur possesses the requisiteexperience and skill, and if the mothers condition permits, he may performversion by thq combined method, but without bringing down the foot into thevagina. The foot should be secured by a fillet. In the treatment of presentation of the funis after dilatation of the cervix, ifthe head remains above the brim and cannot
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
