Difficult labour : a guide to its management for students and practitioners / by G. Ernest Herman.

  • Herman G. Ernest (George Ernest), 1849-1914.
Date:
1901
Catalogue details

Licence: In copyright

Credit: Difficult labour : a guide to its management for students and practitioners / by G. Ernest Herman. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    front of the posterior slioukler. Then, by a repetition of gentle pushing movements, push the anterior shoulder over towards the left side, and the posterior shoulder lowai’ds the right side. You will find it quite ea.sy to move the ehild) only, as the pushes are given, not to the ehild, but to the uterus, part of their effect is to move the uterus. Each push moves the uterus as well as the child, and only slightly alters the position of the child in the uterus. But a sufficient repetition of these movements will, unless the liquor amnii be unusually deficient, or the child’s mobility for some other reason be abnoianally restricted, bring the back to the front. Then the labour may be left to take its natural course. You will sometimes find that this simple change in the position of the child will make a head which was al)Ovc the brim quickly deseeirl into it, press into the os uteri, and convert infrequent and feeble pains into strong and rapidly following ones. 2. Head engaged in the pelvis.—Supposing now that the case is not seen, or the diagnosis not made until the membranes have ruptured, the os uteri has become fully dilated, and the head is engaged in the pelvis. Wait for two or three hours after the full dilatation of the os, and longer if the pains are weak and infrequent, to see if the head will rotate naturally. Supposing it neither rotates nor advances, three courses are open— A. To pull. B. To flex. C. To rotate. A. To pull .—This course has the approval of a high authority—Robert Barnes.* The abnormal position causes increased resistance. Additional force is needed. Apply forceps; pull; take care not to hinder rotation, but leave the turns’to nature. This is in some cases good practice. If you are not called to a case till so late that when you first see it the caput succedaneum is so thick that you * “Obstetric Operations,” 2nd edn., p. 62.