The Practice of Obstetrics

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. 1912 Excerpt: ...fetal head. The degree of dystocia is not in proportion to the size of the tumor, for the latter may be partially cystic, and hence easily reducible in size. In head presentations with a large solid tumor the latter will probably be expelled spontaneously after a period of moulding. In pelvic presentations a high degree of dystocia may result, the trunk and tumor seeking to engage at the same time. If the feet are down, efforts at traction might disrupt the fetus. Diagnosis: This can be made only with the entire hand in the vagina, chloroform having been given. A tumor of this sort might well be confounded with a number of conditions, fetal or maternal. Budin states that the commonest error is the assumption of the presence of a double monster united at the breech. Prognosis: In dystocia the maternal prognosis depends, as in all similar conditions, upon the time at which the diagnosis is made. The outlook for the child is very poor, there being but a small proportion of survivors. Treatment: The dystocia is less than in the case of abdominal tumors. In head presentations traction should be made with forceps until it becomes evident that delivery is impossible. Puncture should be practised in several places in the hope that the tumor is partly fluid. If this fail, the child must be eventrated, after which the legs may be extracted and the tumor treated by morcellation, while in a breech case the tumor must be made to present first with the same intent. Fig. 789.--Sacrococcygeal Tumor In A Female Fetus Born At The Sixth Month.--(Author's collection.) XXIII. FETAL RIGOR MORTIS. Although death of the fetus is of such common occurrence, rigor mortis has been noted so rarely that the possibility of such a phenomenon has been denied. Ballantyne, who has seen one c...