On the management of difficult labour in some cases of abnormal pelvis / by James Armstrong.

  • Armstrong, James.
Date:
[1888?]
Catalogue details

Licence: Public Domain Mark

Credit: On the management of difficult labour in some cases of abnormal pelvis / by James Armstrong. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    turn. Owing to the bulging forwards of the spinal column, I had considerable difficulty in bringing the trunk of the child round the “ false promontory.” At length I managed to liberate the arms. The child was still living. I made every effort to extract the head as soon as possible. It must have been ten minutes before I succeeded, and a male child stillborn was delivered. The weight of the child was unfortunately not ascertained. The head was certainly more than an average size for eight months. The mother made an excellent recovery, and at the end of a fortnight returned home to a distant part of Wales. In this extreme case I think a living child might have been born had labour been induced at the thirtieth week. The amount of forcible traction required to extract the after-coming head, which no doubt killed the child, had no injurious effect upon the mother. Where there is delay in extracting the after-coming head, and the child’s mouth is within reach, a breathing channel can be extemporised by inserting a male catheter into the mouth. I am convinced that this procedure would have been of no avail in this case. The head was so tightly jammed in this irregularly contracted brim, that I could not have used forceps to the after-coming head. To have attempted to deliver a living child at term, with a conjugate at the brim of 2J inches, would have been hopeless. As it was, induction of premature labour was a failure so far as the child was concerned, though as regards the mother it, with turning afterwards, proved alternative to craniotomy. And, though the mother made good recoveries after both craniotomies, I am sure there can be no difference of opinion as to the gravity of the two operations in such an extreme case. I may be allowed to mention that the forceps I referred to was designed by Mr Rawdon, for use in premature cases where there is want of space to apply the ordinary forceps. It was a case of puerperal convulsions at the sixth month, at which he and I were present, and for which induction of abortion was required, that we felt the necessity of such a forceps, and for want of which I had recourse to version. He had this forceps