A system of obstetrics . ntthat the pelvis and the entire birth-canal can only permit this passage if the twins are very small. Cer-tainly, Play fairs law of podalic version is not indicated in the deliveryof this variety of double monsters. It is not necessary to refer to other monstrosities in their connectionwith dystocia. The fact that spontaneous delivery occurs in so manycases, one reason for which is that the labor is often premature, teachesthe obstetrician not to be in haste to intervene; and the difficulty inmany instances of knowing before delivery the kind of monstrositywill make h
A system of obstetrics . ntthat the pelvis and the entire birth-canal can only permit this passage if the twins are very small. Cer-tainly, Play fairs law of podalic version is not indicated in the deliveryof this variety of double monsters. It is not necessary to refer to other monstrosities in their connectionwith dystocia. The fact that spontaneous delivery occurs in so manycases, one reason for which is that the labor is often premature, teachesthe obstetrician not to be in haste to intervene; and the difficulty inmany instances of knowing before delivery the kind of monstrositywill make him then cautious in the mode of intervention. Further,the Cesarean operation is neither indicated nor justifiable in thedelivery of a monstrosity. Dystocia from Anomalies of the Fcrtal Appendages.—Adhesions of the foetus to the placenta or to the membranes have inrare instances caused difficulty in labor, requiring in some artificialbreaking of the adhesions, and in others the foetus and its appendages 1 Veit: op. 788 ANOMALIES OF THE FORCES IN LABOR. have been expelled together. Malformation of the child, possiblyto such a degree that it becomes monstrous, is frequently observedin these cases. Charvet1 has described a cebocephalus in which therewas adherence of the placenta to the cranium and the face. Unusual thinness of the membranes permits their early rupture, andthus premature escape of the amniotic liquor, and from this delay in thedilatation of the os uteri results. If the membranes are preternaturallythick, the membranes may remain entire after the bag of waters has ful-filled its purpose in labor. Generally, the rupture of the sac is readilyeffected by pressing against its most prominent portion with the endof the finger during a uterine contraction; if this should not succeed,similar pressure may be made with a uterine sound or probe, or thenotched nail of the index finger employed in making a to-and-fromovement against the membranes, the nail being thus used
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectobstetrics, bookyear1
