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.

    67/150 (page 63)
    If the knee presents, it is distinguished from the elbow by the presence of the movable patella, which contrasts with the im- movable olecranon of the elbow. The positions of the breech are four in number, named ac- cording to the position of the sacrum. f 1. Left Sacro-Anterior, sacrum directed towards the left pectineal eminence {a) Dorso-anterior (most common position). Right Sacro-Anterior, sacrum directed towards the right pectineal eminence. Right Sacro-Posterior, sacrum directed towards the right sacro-iliac joint. 4. Left Sacro-Posterior, sacrum directed towards the left sacro-iliac joint. 2. 3. (6) Dorso-posterior Position of the Child in Dorso-Anterior Positions.—In the left sacro-anterior position the child lies with its back directed towards the mother’s left side and forwards ; its abdomen is directed backwards, and to the mother’s right side. The left buttock, which lies to the front, presents, owing to the inclina- tion of the mother’s pelvis. Mechanism of Delivery in Dorso-Anterior Positions.— Descent of the breech takes place, and rotation forwards of the anterior hip is produced (by the same mechanism as in vertex presentation), so that the hips are brought into the antero- posterior diameter of the outlet. The anterior hip becomes fixed behind the pubes, and the posterior hip distends,, and then sweeps over the perineum and is born; the anterior hip quickly follows. The shoulders pass down in the same oblique diameter as the hips, and rotate in the same way ; the anterior shoulder then becomes fixed at the pubes, and the posterior sweeps over the perineum. The arms are generally born before the shoulders, but occasionally they become extended over the head, if traction is made on the trunk before they are expelled, and may cause difficulty in delivery of the head. The head enters the pelvis in the opposite oblique diameter to the hips, and becomes flexed on the chest; it then rotates, and the occiput is thus brought