Dr. Conquest's outlines of midwifery : intended as a text-book for students, and a book of reference for junior practitioners.

  • Conquest, Dr.
Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: Dr. Conquest's outlines of midwifery : intended as a text-book for students, and a book of reference for junior practitioners. Source: Wellcome Collection.

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    latter as in the former presentation. The posterior fontanelle during labour loses its triangular shape, and presents only a rough spot formed by the junc- tion of the sutures. If the position of the head cannot be determined by the fontanelles, owing to some deviations from their usual forms, the lobe of the ear will form a good discriminating sign. This part may be easily reached, unless the brim is greatly contracted; and, inasmuch as it is nearer to the occiput than the forehead, it furnishes a ready means of diag;nosis. There is a point connected with vertex presen- tations which presents great interest: it is the general fact established by Naegele, that, when the head is expelled in Baudelocque's second position, it does not assume this direction until the close of the labour, and that it enters the pelvis in the third position (occiput to sacro-iliac symphisis). As nature is gene- rally all-powerful in effecting the necessary rotation, the folly of an early interference in cases of this de- scription is sufficiently obvious. — J. M. W.] It appears that all a practitioner can do towards preventing the rupture of the perineum consists, first, in preventing the head from passing over it until it has acquired sufficient dilatability ; secondly, in preventing the head from passing suddenly over it, even when it has acquired this dilatability; and thirdly, in assisting the head to take its natural di- rection, viz., such as that the occiput turns up before the symphysis pubis. With every precaution, lace-. ration, even to a considerable extent, will sometimes