. The science and art of midwifery. foot isheld out of the way by the attached fillet, the handcorresponding to the childs head may be intro-duced into the vagina, and employed to press thepresenting part away from the cervix. The raisingof the shoulder should be gradual, and should beperformed with the utmost gentleness, as the dan-ger of uterine rupture is peculiarly enhanced bythe thinned, overstretched condition of the lowersegment. Meantime a skilled assistant should exer-cise counter-pressure from without upon the fun-dus of the uterus, and upon the head of the child,and aid the descent
. The science and art of midwifery. foot isheld out of the way by the attached fillet, the handcorresponding to the childs head may be intro-duced into the vagina, and employed to press thepresenting part away from the cervix. The raisingof the shoulder should be gradual, and should beperformed with the utmost gentleness, as the dan-ger of uterine rupture is peculiarly enhanced bythe thinned, overstretched condition of the lowersegment. Meantime a skilled assistant should exer-cise counter-pressure from without upon the fun-dus of the uterus, and upon the head of the child,and aid the descent of the breech by rightly di-rected pressure. Resolution to succeed, combinedwith patience in manipulation, usually overcomesthe obstacles presented by the most difficult cases. In the few instances where failure follows all attempts to accom-plish version, or where rupture is imminent, or where the child isknown to be dead, the obstacle to delivery may be overcome by decapi-tation, and the removal of the head and trunk Fig. 186.—Catheter usedas repositor. CHAPTER XXII. CRANIOTOMY AND EMBRYOTOMY. Craniotomy.—Indications.—Operation.—Perforators.—Method of perforating.—Extrac-tion after perforation.—Forceps.—Cephalotribe.—Action of the cephalotribe.—Ob-jections.—Application of the cephalotribe.—Cranioclast.—Crotchet and blunt hook.—Cephalotomy.—Embryotomy.—Exenteration.—Decapitation. Craniotomy. Craniotomy includes all the various operations employed to reducethe dimensions of the childs head. Thus the term is applied—1. Tothe perforation of the skull, and the evacuation of the brain-contents ;and, 2. To the various procedures subsequently adopted to furtherminimize and extract the cranial walls. Indications for Perforation.—Perforation is resorted to, in cases ofmechanical obstacles to delivery, to overcome the disproportion exist-ing between the childs head and the parturient canal. As the opera-tion is performed solely in the i
Size: 1046px × 2390px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, bookidsci, booksubjectobstetrics
