Aids to obstetrics : double part / by Samuel Nall.

  • Nall, Samuel.
Date:
[1885?]
Catalogue details

Licence: Public Domain Mark

Credit: Aids to obstetrics : double part / by Samuel Nall. Source: Wellcome Collection.

    109/150 (page 105)
    (a) Cephalic Version by the Bi-polar Method.—One or two fingers of the left hand are passed through the cervix, and the shoulder is pushed gradually in the direction of the feet; at the same time the right hand is used externally and presses the head towards the brim. When in position over the brim, the head should be retained there by the right hand, while the left is withdrawn from the vagina, and presses the breech upwards if necessary. (b) Podalic Version by the Bi-polar Method.—By this means a head or shoulder presentation is converted into a foot presenta- tion. If the head presents, its exact position should be made out from the position of the fontanelles. Two or three fingers of the left hand are passed through the cervix, and if the head lies in the first or fourth position, it should be gradually moved on the tips of the fingers to the left, the breech being depressed by the right hand in an opposite direction ; when the shoulder arrives at the os it should be pushed in the same direction as the head; as soon as a knee or foot comes in contact with the finger it should be seized and the membranes ruptured. If the head lies in the second or third position, it should be pushed to the right; when the exact position of the head cannot be made out, it should be pushed to the left, as it generally lies in the first position. If the shoulder presents it should be pushed in the direction of the head. The manipulations should be done in the intervals between the pains. 3. Internal Version.—(a) Cephalic Version is never done by this method, owing to the difficulty of seizing the head and retaining it in position. (b) Podalic Version is easy by this method, if attempted before the liquor amnii has run off. The longer the time that elapses after rupture of the membranes, the greater the difficulty in per- forming the operation, as the uterus becomes tightly contracted on the foetus, and prevents manipulation by the hand. Before turning, the bladder and rectum should be emptied, and chloro- form given to do away with uterine contraction as much as possible. Method.—After the fingers, hand, and forearm have been well oiled on their dorsal aspect, the hand should be passed 7