A manual of obstetric practice : for students and practitioners / by A. Dührssen ; translated and edited from the 6th amended and enlarged ed., by John W. Taylor and Frederick Edge.

  • Dührssen, Jacob Alfred, 1862-1933.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: A manual of obstetric practice : for students and practitioners / by A. Dührssen ; translated and edited from the 6th amended and enlarged ed., by John W. Taylor and Frederick Edge. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    pulse, the discharge is foul, the arm has prolapsed a good distance, and shows signs of decomposition. Tlie shoulder is apparently or really wedged in the pelvis. Prolapse of the arm in cross-births is unfavoui-able to the accoucheur, in so far as it presumes a deeper position of the shoulder, which renders version more difficult; it is favourable in so far as the accoucheur need not free the arm in any ex- traction afterwards. The prolapsed arm does not hinder the turning. A loop is put on it, and the loop is kept modei'ately tense during the turning. This pulling directed toward the abdominal side of the foetus is especially important during extraction, because the arm otherwise easily slips behind the neck, and afterwards is broken by pulling on the loop. Prolapse of the funis occurs in 9 per cent, of all cross- births according to Winckel. The treatment of cross- birth is not in any way afFected by this accident. Reposi- tion of the funis is not practised in cross-births. Extraction by the Foot. Extraction by the foot is only performed when danger to the mother or child demands the termination of the labour. An exception to this rule is a foot presentation brought about by turning. Here many obstetricians, among whom is Gusserow, recommend that extraction be at once pro- ceeded with, provided that no contra-indication exists, that is that the os uteri is fully dilated. This advice is good for a practised accoucheur, but the beginner does better by controlling the foetal heart sounds after turning, and extracting only when these are not to be heard, or are getting slower and slower. The mortality of children after turning alone is not higher than that of turning and extraction (50-60 per cent.).