A manual of practical obstetrics . OR TURNING Version by Combined Manipulation.—When versionby external manipulation is necessarily impossible, or hasfailed after trial, the second least dangerous method, by com-bined manipulation, should be tried. This consists of manip-ulating outside with om hand, while the other is passed into Fir; 94. II Bipolar version (first step. the vatjiini. two or three of its finr/ers only going into theuterus. The hand outside pushes down the pan it is desiredto bring to the superior strait, while the ringers inside simul-taneously move the part at the os out of t
A manual of practical obstetrics . OR TURNING Version by Combined Manipulation.—When versionby external manipulation is necessarily impossible, or hasfailed after trial, the second least dangerous method, by com-bined manipulation, should be tried. This consists of manip-ulating outside with om hand, while the other is passed into Fir; 94. II Bipolar version (first step. the vatjiini. two or three of its finr/ers only going into theuterus. The hand outside pushes down the pan it is desiredto bring to the superior strait, while the ringers inside simul-taneously move the part at the os out of the way and upward VERSION BY COMBINED MANIPULATION. 235 along the opposite side of the pelvis. Thus, in head presenta-tions, when it is desired to bring down the feet, the operationcomprises three steps: 1. The fingers inside lift the head toward that iliac fossatoward which the occiput points, while the hand outsidedepresses the breech along the opposite side of the womb(Fig. 94, page 234). This having been done— Ftg. <)... Bipolar version (second step). 2. The fingers inside can now touch the shoulder, and theypush or lift it in the same direction as the head, while thehand outside still further depresses the breech (Fig. 95). Thehead is now a little higher above the brim than the breech,and the knee is within reach of the fingers. 3. Grasp the knee (the membranes, if unbroken, may beruptured), and pull it down, while the hand outside changes 236 VERSION OR TURNING its position so as to push up the head toward the fundus(Fig. 96). The foot may now be reached and the case man-aged as a breech or footling presentation. In transverse presentations the operation comprises the secondand third steps above given for head cases—that is, push theshoulder after the head, then grasp the knee, etc. Should itbe desired, however, to convert the shoulder (transverse) pres- Fig. 96.
Size: 1300px × 1922px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, bookpublisherphila, bookyear1895
