A manual of practical obstetrics . Extraction of head in breech cases. The means for rapid delivery of head when it has descendedto the inferior strait, and occiput has rotated to the pubes,are: Ergot (hypodermically if the case be urgent); manualpressure upon fundus uteri through the abdomen by a skilledassistant previously secured; urging the woman to bear downduring a pain, with all the voluntary effort she can command ;and traction judiciously applied thus: support body in left 10 218 BREECH, KNEE, AND FOOT PRESENTATIONS. hand, one or two fingers of which may be passed in alongposterior va
A manual of practical obstetrics . Extraction of head in breech cases. The means for rapid delivery of head when it has descendedto the inferior strait, and occiput has rotated to the pubes,are: Ergot (hypodermically if the case be urgent); manualpressure upon fundus uteri through the abdomen by a skilledassistant previously secured; urging the woman to bear downduring a pain, with all the voluntary effort she can command ;and traction judiciously applied thus: support body in left 10 218 BREECH, KNEE, AND FOOT PRESENTATIONS. hand, one or two fingers of which may be passed in alongposterior vaginal Avail to childs mouth, or to upper jaw bone,one finger being on each side of the nose, and its chin de-pressed toward its chest, while two fingers of the right handare passed in under pubic arch and pressed upon the occiputso as to tilt it up and assist flexion. (See Fig. 81, page 217. Fig. Manual extraction of after-coming head. (From Galabin.) Thus, during traction, the chin-pole of occipito-mental diameteris made to escape over perineum and delivery follows. Thefinger (or two of them) of the left hand may also be passedinto rectum and made to press through the recto-vaginal wallupon the forehead, thus again promoting flexion. Another method. Seize the feet with the right hand, andhook the left hand over the back of the neck (Fig. 82). TREATMENT OF BREECH CASES. 219 Traction on the legs is now made in a direction almost at rightangles to thepubes, so that the resistance of pubic bones, im-pinging against occiput, pushes it up, while chin and face flexand descend along sacrum, escaping at perineum. The lefthand steadies the head, prevents its too sudden escape, andalso assists the right in making traction. The hand of anassistant, pressing upon fundus uteri, will expedite the process,as in the first method described. In cases of sacroposterior positions where anterior r
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