A textbook of obstetrics . pelvic inlet, as in mal-position of the fetus, a head of abnormal size, a displaced uterus,twins, hydramnios, contracted pelvis, and anomalous shape ofthe uterus. In the treatment of compound presentations before rupture ofthe membranes an attempt should be made to overcome thedifficulty by postural treatment. The woman should be placedon that side opposite the prolapsed extremity. After rupture ofthe membranes an attempt should be made to dislodge the pro-lapsed extremity and to restore it to its natural position. Version 1 Diss. Enaug., Berlin, 1S90. ;iS THE PATHOL
A textbook of obstetrics . pelvic inlet, as in mal-position of the fetus, a head of abnormal size, a displaced uterus,twins, hydramnios, contracted pelvis, and anomalous shape ofthe uterus. In the treatment of compound presentations before rupture ofthe membranes an attempt should be made to overcome thedifficulty by postural treatment. The woman should be placedon that side opposite the prolapsed extremity. After rupture ofthe membranes an attempt should be made to dislodge the pro-lapsed extremity and to restore it to its natural position. Version 1 Diss. Enaug., Berlin, 1S90. ;iS THE PATHOLOGY OF LABOR. may, however, be required if this attempt foils, or even crani-otomy if the child is dead. If the head and extremities present,and if the former is engaged, it is usually best to apply forcepsand to disregard the prolapsed extremities. In the case ofnuchal position of the arm, an effort should be made to dislodgethe latter, but it may be necessary to fracture it before thedelivery of the child can be Fig. 397.—Twins ; breech and face presentations. Multiple Births.—Twin labors are usually easy and uncom-plicated (75 per cent.), but complications are more frequentthan in single labors. Malpresentations are common. Thefollowing table from Spiegelberg, based on 1138 labors, givesthe combined presentations in the order of their frequency: Both heads presenting, 4 percent Head and bree< h, . ... Both pelvic presentations, Head and transverse Breech and transverse, 4-*4 Both transverse, 35 ANOMALIES IX THE FORCES OF LABOR, 59 It may be noted that a transverse position is found in percent, of cases. Mechanical difficulties in labor are frequent: theuterine muscle is usually weakened by overstretching, and theremay be trouble in the third stage of labor in the delivery of the placenta. Some form of operative interference is demanded inabout 25 per cent, of all cases.
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
