. The science and art of midwifery . skull. M M,bimastoid diameter, TREATMENT OF CONTRACTED PELVES. 505 Tractions upon the trunk of the child Bring to hear simultaneouslypressure upon the head from many points in the pelvic walls. As aresult, bilateral flattening is effected, and a deep groove, usually near thecoronal suture, is produced in many cases upon the posterior cranialsurface by the pressure of the projecting promontory. The hulk of thehead is still further diminished by an overriding of the bones at theBagittal suture, and, where the transverse diameter is insufficient, bythe crowdin
. The science and art of midwifery . skull. M M,bimastoid diameter, TREATMENT OF CONTRACTED PELVES. 505 Tractions upon the trunk of the child Bring to hear simultaneouslypressure upon the head from many points in the pelvic walls. As aresult, bilateral flattening is effected, and a deep groove, usually near thecoronal suture, is produced in many cases upon the posterior cranialsurface by the pressure of the projecting promontory. The hulk of thehead is still further diminished by an overriding of the bones at theBagittal suture, and, where the transverse diameter is insufficient, bythe crowding of the occipital beneath the parietal bones. A reductionof the cranial contents is brought about by the retreat of a consider-ate portion of the cerebro-spinal fluid into the spinal canal. All thesechanges are induced rapidly, and are not dependent upon the activityand strength of the uterine pains. The method of performing version and extraction in contractedpelves is, with few modifications, the same as in pelves of normal Fig. 212.—Method of employing suprapubic pressure. Head in the pelvic cavity. (Munde.) In contracted pelves great care requires to be taken lest the arms be-come reflected upward to the sides of the childs head, or crossed uponthe neck. To avoid this difficulty it is desirable to introduce thehand over the abdomen of the child, and bring down the arms beforethe engagement of the shoulders. In extracting the head, tractionsmay he made upon the lower extremities and shoulders according tothe method of Kiwisch, or they may be made with one hand uponthe shoulders, while two fingers of the other are inserted into thechilds mouth. Provided by either of these methods the relation ofthe head to the shoulders is such that no twisting of the neck takesplace, the amount of force that can be employed without producing 506 TflE PATHOLOGY OF LABOR. fatal lesions is often something astounding. Thus, Rokitansky,* ex-perimenting with the bodies of still-born infa
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