. The science and art of midwifery. n of version must be decided with referenceto the interests of the mother, as a difficult breech delivery complicatedby prolapsed funis offers but a sorry prospect of saving the life of thechild. If the membranes rupture and the cord is prolapsed while the cer-vix is still narrow and rigid, an attempt should first be made to pushback the cord with two fingers after placing the woman in the genu-pectoral position. As a rule, however, instrumental replacement willbe necessary. I have been in the habit of employing for the purpose,as recommended by Dudan, a lar
. The science and art of midwifery. n of version must be decided with referenceto the interests of the mother, as a difficult breech delivery complicatedby prolapsed funis offers but a sorry prospect of saving the life of thechild. If the membranes rupture and the cord is prolapsed while the cer-vix is still narrow and rigid, an attempt should first be made to pushback the cord with two fingers after placing the woman in the genu-pectoral position. As a rule, however, instrumental replacement willbe necessary. I have been in the habit of employing for the purpose,as recommended by Dudan, a large English catheter, which possessesthe advantage of forming one of the ordinary properties of the phy-sician. The method of using the instrument is as follows : A pieceof tape should first be fastened loosely around the cord, the styletshould then be made to emerge at the eye of the catheter, and a loopof the tape should be placed in the angle it forms. By returning the * Nederl. Weckbl., April, 626 THE PATHOLOGY OF stylet and pushing it forward to the extremity of the tube, the band isheld firmly. After replacing the prolapsed cord, the catheter is read-ily detached by the withdrawal of the stylet. Braun von Fernwald,who is the author of the best of the repositors made expressly for theprolapsed cord, says that the catheter is almost the only instrumentto which he now resorts. Instrumental replacement is apt to prove a veritable labor of Sisy-phus. As one loop is pushed up another comes down, or the entire mass is returned with infinite trou-ble to the uterus only at once to beprojected into the vagina. Robertonhas proposed a handy plan for suchcases, which certainly merits a consists in first passing a piece oftwine doubled through an elasticcatheter, so that the loop makes itsappearance at the eye. Throughthis loop, a loop of the cord shouldbe drawn. The ends of the twineshould then be knotted to preventthem from slipping ; the cathetershould be arm
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Keywords: ., bookcentury1800, bookdecade1890, bookidsci, booksubjectobstetrics
