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
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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.

    142/370 (page 128)
    Should the cause of impediment in these cases be trifling and compressible, powerful parturient efforts may overcome it; but if it be larger or incompres- sible, the case may require the forceps, scalpel, or perforator. No invariable direction for the manage- ment of these cases can be given, because much must depend on the consistence, size, and situation of the obstruction. Some tumours may be elevated, and kept above the brim of the pelvis until the pre- senting part occupies the superior aperture; and others of tliem may be safely punctured.* Various other causes of protracted labours of the division now under consideration are mentioned by writers, such as cribrated hymen, contraction of the vagina, either congenital or the result of disease, &c., but these are of very rare occurrence, and are usually overcome by the unaided powers of the uterus; and if not, the scalpel must be used, the greatest care being taken to divide the obstructing part. [_Hydrocqjlialic enlargement of the head will some- times offer a serious obstruction to delivery. It is distinguished by the width of the sutures: the head, moreover, feels as if it were a tumour filled with fluid. These cases will frequently do well without instru- mental aid. If necessary, the head must be perfo- rated.—J. M. W.] * Much interesting and important information on these points Is to be found in a variety of publications, and particularly in the 2nd, 3rd, and 10th volumes of the Mcdico-chirurgical Transactions. In the Cliniquc Cliirurgicale, tome i. there are several instructive eases, by Messrs. rellctiii.