Identifier: practiceofobstet00edga (find matches)
Title: The practice of obstetrics, designed for the use of students and practitioners of medicine
Year: 1910 (1910s)
Authors: Edgar, J. Clifton (James Clifton), 1859-1939
Subjects: Obstetrics
Publisher: 3rd ed., rev
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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on, which, being capable of continued im-provement, have greatly benefited the chances for survival of the child. Therefore 1004 OBSTETRIC SURGERY. it is not surprising that many obstetricians advise doing away with instru-mental delivery in these cases altogether. A majority, however, are in favorof using the forceps in certain cases, although the indications appear to bemuch confused in most standard books. The forceps is indicated in but a verysmall proportion of cases of after-coming head. It is positively contraindicatedwhen the head is above the brim, for if manual extraction is unsuccessful thehead will probably have to be perforated, since the child will almost certainly bedead. The indications for the forceps are three in number, (i) The head is inthe excavation with its long diameter antero-posteriorly or oblique, and, man-ual procedures having failed, immediate delivery is necessary to save the childslife Experience has taught me that now and then a fetal life may be saved.
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Fig. 1231.—The Forceps Applied to the After-comixg Head in a Sacro-anterior Position. (2) In abnormal rotation with the head extended, the face in front, and the chinover the symphysis. (3) In cases in which prolonged traction on the trunkthreatens to rupture the childs neck. Such an accident might readily occur ina fetus long dead or in the presence of some disease. If the head is thus leftbehind, we have the condition known as detached head, to be described later.Technique: The general rule in vertex anterior cases is to apply the forcepsbelow the child, which is lifted upon the mothers abdomen by the legs, carebeing taken not to stretch its neck. The arms are raised with the trunk;the forceps is applied in the usual manner, care being taken not to grasp thecord. Traction should be made in the direction of the handle until the chinappears. Thereupon the nuchal surface of the child should be made to rotatebeneath the pubic arch, the handles being turned toward the mothers ab- THE F

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