Practical midwifery; handbook of treatment . in no way from that already described underHead Presentations. Much has been written on the advantage to be gained by se-lecting the superior foot, in version for transverse presentation;but as this view has never obtained much credence outside ofEngland, and as the latest British authority, Gralabin, not onlydisapproves of this practice but gives a very convincing mechani- 180 PRACTICAL MIDWIFERY. eal proof of the fallacy of the theory which prompted it, the sub-ject need be no more than mentioned here. Unless special care be taken to select the su
Practical midwifery; handbook of treatment . in no way from that already described underHead Presentations. Much has been written on the advantage to be gained by se-lecting the superior foot, in version for transverse presentation;but as this view has never obtained much credence outside ofEngland, and as the latest British authority, Gralabin, not onlydisapproves of this practice but gives a very convincing mechani- 180 PRACTICAL MIDWIFERY. eal proof of the fallacy of the theory which prompted it, the sub-ject need be no more than mentioned here. Unless special care be taken to select the superior foot, thelower is almost invariably seized. Difficulties and Complications of Internal Version.—T^he diffi-culties encountered in version are usually due to one of threeconditions: Either to the presence of an imperfectly dilated andrigid OS; to partial impaction of the presenting part; or to clasp-ing of the child, either generally by a dry and retracted uterus,or locally by a spastic hour-glass contraction—a constriction Fig. 40.—Direct Method op Seizing a Foot (LrsK). Rigid Os.—When version is indicated in the presence of a par-tially dilated or rigid os, it must usually be preceded by an opera-tive dilatation by one of the methods which were described inChapter X. If this operation is to be followed by version, thedilatation should be carried to the highest degree which is possiblebefore turning is attempted, in order to minimize the danger of areclosure of the os about the neck during the extraction of thechild. Partial Impaction.—A well-fixed head already deeply engagedis usually a case for forceps rather than version. There are, hoAv-ever, many cases of arrest from extended head, or of brow presen-tation, which are unsuited for forceps and must be treated byversion, and in these cases it is essential that flexion should berestored, by j)ressure upon the forehead, before any attempt is OBSTETRIC SURGERY. 181 made to raise the head; for not only is
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectmidwifery, bookyear18
