Abdominal Examination and Manipulation in Pregnancy (Paperback)

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: CHAPTER XIII. ONSET OF LABOURFIXATION OF THE HEADPROGRESS. Onset of Labour: Question of in Primiparse-in MultipartPains Fixation of Presenting PartDescent. Fixation of the Head: Completion ofSignificance ofSignificance of Failure to Become Fixed. Progress: Method of AscertainingPresumption of Dilatation of the Os from Onset of DescentPrognosis from the Rate of Descent and Amount of Flexion. ONSET OF LABOUR. The decision regarding whether labour has begun or not is best made after abdominal palpation. If the subjective pains coincide with the objective contractions of the uterus, and if these contractions are occurring sufficiently often, labour may be pronounced to have set in. During palpation, especially in multiparse, painless contractions are sometimes set up by the manipulation entailed by palpation. Colic, accompanied by painless contractions, simulates labour very closely; but there is a want of correspondence between the pains and the uterine contractions. It is sometimes necessary to make the decision regarding entrance to hospital depend on whether the gravidum be in labour or not. In primiparae the evidences, both abdominally and vaginally, are definite, and the question can be decided precisely. Should a mistake arise there is time to have it rectified. In primiparse rhythmical contractions of the uterus, accompanied by pain, mean the onset of labour. The fixation of the head, which is a sign of labour, implies, besides other conditions, that there has been sufficient uterine contraction or increased intra- abdominal tension to force the biparietal diameter through the brim. This takes place from two to six weeks before term, though Pinard puts it down as occurring during the last three months of pregnancy, and thinks that i...