A treatise on the science and practice of midwifery . ly detected. These alterations were found to be mostfrequent in multipara^ and the tendency was for abnormal presentationsto alter into normal ones. Thus it was common for transverse pres-entations to alter longitudinally, and but rare for breech presentationsto change into head. The ease with which these changes are effected nodoubt depends, in a considerable degree, on the laxity of the uterineparietes and on the greater quantity of amniotic fluid, by both of whichthe free mobility of the foetus is favored. Detection of Foetal Position by
A treatise on the science and practice of midwifery . ly detected. These alterations were found to be mostfrequent in multipara^ and the tendency was for abnormal presentationsto alter into normal ones. Thus it was common for transverse pres-entations to alter longitudinally, and but rare for breech presentationsto change into head. The ease with which these changes are effected nodoubt depends, in a considerable degree, on the laxity of the uterineparietes and on the greater quantity of amniotic fluid, by both of whichthe free mobility of the foetus is favored. Detection of Foetal Position by Abdominal Palpation.—The facilitywith which the position of the foetus in utero can be ascertained byabdominal palpation has not been generally appreciated in obstetricworks, and yet by a little practice it is easy to make it out. Muchinformation of importance can be gained in this way, and it is quitepossible, under favorable circumstances, to alter abnormal presentationsbefore labor has begun. For the purpose of making this examination Fig. Mode of Ascertaining the Position of the Foetus by Palpation. the patient should lie at the edge of the bed, with her shoulders slightlyraised and the abdomen uncovered. The first observation to make is tosee if the longitudinal axis of the uterine tumor corresponds with thatof the mothers abdomen; if it does, the presentation must be either ahead or a breech. By spreading the hands over the uterus (Fig. 67) agreater sense of resistance can be felt, in most cases, on one side than onthe other, corresponding to the back of the child. By striking the tipsof the fingers suddenly inward at the fundus, the hard breech cangenerally be made out, or the head still more easily if the breech bedownward. When the uterine walls are unusually lax, it is oftenpossible to feel the limbs of the child. These observations can begenerally corroborated by auscultation, for in head presentations thefoetal heart can usually be heard below the umbilicus,
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectobstetrics, bookyear1
