File:The practice of obstetrics, designed for the use of students and practitioners of medicine (1910) (14591150197).jpg

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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the Walcher position asusually assumed, the direction of the axis of the utero-vaginal canal is almostperpendicular, and traction with the hand or forceps must be directly down-ward. For this reason a combination of the Walcher position with the well- 876 OBSTETRIC SURGERY known Trendelenburg is advised.* In this way the advantages of the formerposition are realized while the vulva is at such a height that traction can con-veniently be made. The axis of the utero-vaginal canal is horizontal andmanipulations are thus facilitated. A satisfactory table for this position maybe improvised by means of an ordinary inverted chair and a mattress. Conclusions.—From the foregoing the following conclusions may be deduced:(i) When the head is arrested at the pelvic brim, either the Walcher or theWalcher-Trendelenburg position is worthy of trial. (2) For all operative casesin which the greatest circumference of the head has passed the brim, the ex-aggerated lithotomy position is to be preferred.
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Fig. 1049.—Knee-chest Posture, showing the Parturient Tract and the DegreeOF Pelvic Inclination.—(From a photograph taken at the Emergency Hospital.) Posture as an Aid to Childbirth.—In retroversion of the pregnant uterus thepatient should be placed in the knee-elbow or the exaggerated latero-prone posi-tion, in order that reposition of the uterus may be attempted. In over-strong pains,to prevent precipitate labor the patient should be placed upon her side and for-bidden to bear down. In labor in contracted pelvis, with slight disproportion be-tween the head and inlet, Walchers position should be assumed during engage-ment in the inlet. If a similar degree of contraction exists at the outlet, theexaggerated lithotomy position should be assumed. In the ftrst stage of labor pos-ture is generally left to the decision of the parturient. She may be seated or may* Dickinson: American Journal of Obstetrics, Dec, 1898, p. 791 POSTURE IN OBSTETRICS. 877 walk about. An upright position is

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