Licence: Public Domain Mark
Credit: Practical manual of obstetrics. Source: Wellcome Collection.
Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.
80/430 page 50
![2. Foetal movements (two kinds of signs). p • C Either imparted (Stoltz), that (probable'sigB). j ment * . • ( Or spontaneous (Stoltz); it is (certahTsigns). ] necessary that they be per- v ( ceived by the accoucheur. Remarks. Changes in the Superior Portion of the Uterus.—Above (§ 1) we have spoken of the uterine changes relative to its gradual increase; hence we need not revert to them here. We add simply, regarding consistence, that we sometimes obtain on palpation a cystic sensation and even an actual fluctuation. The form of the uterus, which resembles when empty that of a pear, becomes spheroidal at first, and ovoid at the end of gestation. Its direc- tion, from right to left and from above downward, may exceptionally be quite central or from left to right. Finally its position, that is to say its torsion, is such as to render the left lateral wall slightly anterior. This torsion is more manifest in certain animals. Foetal Movements.—As the table indicates, they are of two orders, the passive and the active movements. The passive movements are those communicated to the foetus by abdom- inal ballottement. This phenomena, as we have stated above, gives to the examiner the sensation of a mobile body floating in a liquid, and constitutes a probable sign, obtained either by palpation or by touch. By combining these two modes of exploration already described, we can obtain a new manifestation of abdominal ballottement. The finger being placed in the vagina (as for touch) can elevate the foetal portion by a smart push given in the anterior cul-de-sac to the infe- rior segment of the uterus ; and the left hand, if the right be employed for the touch, being placed flat on the abdomen, will perceive the impetus of the foetus which will strike it and will then drop back on the exploring finger ; under these circumstances, the ballottement will be a sign of great probability. The active movements are those executed by the foetus spontaneously or under the influence of a slight excitation. They are to be perceived by the woman, generally, toward the middle of pregnancy, that is to say, at four and a half months. However, several causes of error exist, especially in women pregnant for the first time ; being very feeble at first, almost insensible and compar- able to tickling, they become by degrees more marked and soon resem- ble undulations or shocks, which the flat hand, applied to the abdomen, or even the eye can perceive.](https://iiif.wellcomecollection.org/image/b2100013x_0080.jp2/full/800%2C/0/default.jpg)
