Operative midwifery : a guide to the difficulties and complications of midwifery practice / by J. M. Munro Kerr.

  • John Martin Munro Kerr
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: Operative midwifery : a guide to the difficulties and complications of midwifery practice / by J. M. Munro Kerr. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    occipital end of the head being lowermost, the fingers can be sunk deeper into the pelvis on that side, or, to put it differently, the Bide on which the fingers sink deepest is the side to which the occiput is directed. In face and brow presentations, as we shall see, it is quite otherwise. With them the occiput is higher, and is felt unusually prominent. These and other points, however, will be considered in connexion with the different positions and presentations. Similarly, the appreciation of the relative size of the foetal head and maternal pelvis, so important a guide to treatment, and the appreciation of the presence of more than one fcetus, will be considered when these subjects are under discussion. Vaginal Examination.—Cntil recent years the accoucheur made his diagnosis of the position, presentation, etc., of the fcetus entirely ] Fig. 8.—Palpation of the Fcetal Part situated at the Sides of the Uterus. by a digital examination per vaginam. If one looks at the obstetric textbooks of a comparatively few years ago, one finds this method of examination the only one seriously discussed, while even at the present moment a large majority of practitioners still employ it almost exclusively. The perfecting of abdominal palpation, but, above all, the demon- stration that every vaginal examination is a distinct danger to the parturient, has led the more enlightened and thoughtful to limit vaginal examinations as far as possible. Some enthusiasts would dispense with the latter altogether ; but it is perfectly evident that such an extreme position is untenable, for there are many conditions, both maternal and foetal, which can only be appreciated by vaginal examination. Amongst these may be mentioned small tumours in the pelvis, rigidity of the cervix, and, indeed, not infrequently, many