Obstetric Accidents, Emergencies, and Operations (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1896 edition. Excerpt: ... CHAPTER II. DIFFICULTIES IN LABOR DUE TO SOME ABNORMALITY OF THE FETUS. Hydrocephalus.--This dropsy of the head is usually a serous effusion confined to the cerebral ventricles, and sometimes creates great difficulty in labor. Hydrocephalus occasionally constitutes an insurmountable obstacle to parturition. When the effusion is smaller, delivery may still be possible, owing to the flexibility and the softness of the head, the walls of which are nearly membranous; so that by gradually moulding itself to the passage the head becomes lengthened out, and the labor is either terminated by the powers of nature alone, or is effected without much difficulty by the application of the forceps or by podalic version. When, on the contrary, the effused water exists in great abundance, the dimensions of the head (Fig. 56) so much exceed those of the diameters of the pelvis that delivery is absolutely impossible, unless the fluid be evacuated by an artificial puncture or by a spontaneous rupture of the sutures or fontanelles. In a case reported by Weisberg the child's head was 1o inches long and 36 inches in circumference. Meckel and Burns record similar cases. Diagnosis.--The following, according to Duges, are the signs whereby a dropsy of the head may be recognized during parturition: The finger falls upon a large and slightly convex surface, which covers every part of the superior strait without engaging, and which has a variable consistence at different points; for, although hard and resistant while the pain lasts, it is, on the contrary, soft and fluctuating in some places during the intervals between the contractions. By passing the index finger slowly over this surface the accoucheur can rec Fig. 56.--Hydrocephalus distending lower uterine segment...