A manual of midwifery : including the pregnancy and the puerperal state / by Karl Schroeder ; translated into English from the third German edition by Charles H. Carter.

  • Karl Schroeder
Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: A manual of midwifery : including the pregnancy and the puerperal state / by Karl Schroeder ; translated into English from the third German edition by Charles H. Carter. 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.

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    CHAPTER IV THE VARIOUS POSITIONS OF THE FOETUS It lias already been mentioned that there is during pregnancy great variety in the position and attitude of the foetus within the uterus. Shortly before the commencement of labour in primiparsa the head of the foetus has, as a rule, already entered the pelvis, but in pluriparae the head is movable above the pelvic inlet, or some- what deviated to one of the two sides. Exceptionally that deviation is so great that the commencing uterine contractions are unable to bring the longitudinal axis of the foetus into that of the uterus, so that during parturition the child is in a more or less transverse position. In other cases it happens that under the conditions men- tioned above the breech is above the pelvic inlet, or at Last nearer to it than the head. A breech presentation is, then, produced when the commencing pains try to fix the foetus in its longitudinal axis. It follows from what has just been said that transverse presenta- tions during parturition are very rare in primipare, and that they are always caused by considerable abnormalities (mostly pelvic deformities), whilst in pluriparse it is more frequently the case. If the head is directed downwards, and the foetus has its normal attitude, the skull will be presenting; but if the chin is removed from the chest, and the head is flexed on the nape, the face will be tlif ]>resenting part. If the pelvic end is directed downwards, and the foetus has its normal attitude, t lie breeeh will be the lowest part; perhaps the feel may be felt by the side of it, but they will remain behind in the further course of parturition. In rare eases the thighs may be removed from the abdomen, and the feet will then descend im-' the os uteri before the breech. Or, as very seldom occurs, the legs may remain in apposition to the thighs, and the knees can be felt within the OS. Ji' Only one foot lias descended whilst the other remains fixed against the abdomen, this^presentation is called imperfect. 'I'll.- positions of the foetus are, therefore, t<> be distinguished as— C 1. Cephalic end - '/' ,,'' [ presentations. t mi i •, v i \ i b. Face S I. The longitudinal. - - i. i i i o i> l • -I • Breech ) ,. (^ a. Feme end -. , ,, .,. v presentations. v ( D. loot ling ) L I r. The transverse. All agree in this thai the transverse positions belong to the pathology of parturition, because as such they are usually insuper-