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

  • Herman, G. Ernest (George Ernest), 1849-1914.
Date:
1895
Catalogue details

Licence: Public Domain Mark

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 Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    reason given why it should not occur, it is very rare. If the occiput does not rotate forwards, the uterus drives it down, and it revolves round the symphysis pubis, having the forehead as its centre of rotation (Fig. 7), and thus is born. Then the nape of the neck becomes fixed against the perineum, and the nose, mouth, and chin slip out from behind the symphysis pubis. This is the usual way, and with a full-sized child the only way, of de- livery when the occiput does not rotate to the front. The head born with the occiput behind shows characteristic de- formity. The occipito- frontal measurement is shortened, the verti- cal measurements are increased. The back and front of the head alike rise up steeply from the face and neck respectively. On the average, labour with the occiput behind is longer than when the occiput is in front. Delivery with the occiput behind is especially apt to occur with very small or very large children. With small children extension can occur in the pelvis; with large, it is produced above the brim. Cases in which treatment is required. -When the occiput is behind, labour is likely to be delayed because the occiput has to make a long rotation to get forward under the pubic arch. Although this rotation takes place in most cases, yet in some (about 1} per cent, of vertex presentations) it does not. Fig.' 7.—Showing Mode of Delivery when Occiput does not rotate forwards.