A practical treatise on midwifery / by M. Chailly ... A work adopted by the Royal council of public instruction. Tr. from the French and ed. by Gunning S. Bedford.

  • Chailly-Honoré, Nicolas Charles, 1805-1866.
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on midwifery / by M. Chailly ... A work adopted by the Royal council of public instruction. Tr. from the French and ed. by Gunning S. Bedford. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

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    vis will permit the spontaneous descent of the head, the hfe of the foe- tus will be less frequently endangered than if it be brought down by the pelvic extremity; and the difficulties of the delivery will also be less for the mother. But the mother will derive important benefit from cephalic version when the contraction is very marked, and the per- foration of the cranium and cephalotribe become indispensable. It will enable us to act on the head, and thus more promptly and certainly save the mother, than by mutilation of the foetus while it presents the shoulder. A. Operation in Cephalic Version.—The rules laid down by Flamant and M. Velpeau for version when the shoulder is yet at the superior strait, are the following: When the position of the head has been ac- curately ascertained by the abdominal percussion and the touch, the accoucheur introduces two or three fingers into the maternal organs, and fixes them on the shoulder; he raises the shoulder, and endeav- ours to remove it from the superior strait by directing it towards the side corresponding with the pelvic extremity, in order to allow the head to descend, while, at the same time, he endeavours to bring the head to the superior strait, with the left hand applied to it, through the abdominal walls. This method is the most simple, least painful, and sal'est; it is the one recommended, under these circumstances, by M. P. Dubois, and which I have already suggested previous to the rupture of the membranes 5 unfortunately, it is very rarely successful after the rupture. The foetus does not. enjoy sufficient mobility to allow itself to be displaced in this manner, and we are then obliged to have recourse te pelvic version. As to the second method, it merits all that I have said of cephalic version; its execution is accompanied with all the difficulties and dangers which I have enumerated above. The hand, the palm of which regards the back of the foetus (the choice of the hand is not strictly indicated), penetrates entire the ma- ternal organs; when it reaches the uterine orifice, it raises the shoul- der, pushes it towards the iliac fossa, in which are situated the inferior extremities; it then seizes the head by the occiput, and engages it in the superior strait, and maintains it there until the contractions of the uterus have firmly fixed it in this point. The rest of the delivery is to be intrusted to the spontaneous effort, and in the absence of uterine contraction, the forceps must be applied. Finally, we must proceed as in cases in which a deformity of the pelvis complicates the presentation of the vertex. If all the difficulties encountered in this operation be duly consider- ed, it will not seem strange that, in our day, the operation should have been abandoned, even in cases of pelvic deformity, and that the at- tempts of the German school again to restore it to confidence have not met many admirers among us. It is not, however, right entirely to proscribe it, as some accoucheurs have done ; for it is evident that, if it be practicable in a case of pel- vic contraction, both the infant and mother will be placed in more fa- vourable circumstances than if pelvic version be resorted to (see Pelvic Version) 3 and, therefore, it should be attempted in this instance.