368 



FOETAL DYSTOKIA, 



BOOK II. 



FCETAL DYSTOKIA. 



Though the obstacles to parturition offered by the maternal organs are 

 somewhat considerable in number, yet it is found in practice that those 

 due to the foetus are far more frequently met with, and are much more 

 numerous ; though all of them may not constitute real or serious obstacles, 

 some being easily removed or overcome, when birth takes place without 

 any difficulty. , 



The obstacles which the foetus may offer to birth are, for convenience 

 of study, divided into two natural groups, according as they result from 

 some physical condition of the young creature itself, or from the more or 

 less irregular manner in which it is presented at the pelvic inlet. Each 

 of these groups, again, it is needless to add, embraces a certain number 

 of varieties of obstacles ; but though grouped and classified in this way, 

 we must remember that difficult parturition due to the foetus may not be 

 owing exclusively to any one of these obstacles in every case, but in some 

 instances may result from a combination of two or more of them. 



But this combination does not preclude us from studying them sep- 

 arately ; indeed, their separate consideration is absolutely necessary, as 

 it is only by analyzing them that we can realize their influence in hin, 

 dering birth, either when alone or combined. 



As will be seen from the following synoptic table, these obstacles are 

 very numerous and -varied, and require careful consideration from the 

 obstetrist : opening, as they do, a wide field for investigation and reflec- 

 tion, as well as practical deduction. 



The two groups referred to consist (i) of the obstacles independent of 

 presentations and positions, and (2) of the malpresentations and positions 

 of the foetus, and the difficulties resulting from them. 



Synoptic Table of Fcetal Dystokia. 



Excess in Volume of the Fa:tus. 

 Anomalies in, and Diseases of the Postal Membranes 

 Abnormal Quantity of Placental Pluid. 

 Anomalies in the Umbilical Cord. 



Q^ 



Independent 

 of the Pre- 

 sentations. 



Diseases 



Resulting 

 from the 

 Presenta- 

 tions. 



Death. 



Monstrosities. 



Multiparity. 



' Anterior - - 



Posterior. - • 

 Transverse • 



' Hydrocephalus. 



Ascites, Anasarca, and Hydrothorax. 

 Emphysema. 

 Polysarcia. 

 Contractions. 

 Tumors. 



Incompletely Extended. 



Crossed on the Neck. 



Flexed at the Knees. 



Completely Retained. 



Bent Downwards and Backwards. 



Bent Laterally. 



Bent Upwards and Backwards. 

 Hind Quar- j Forced Abduction of the Limbs. 



ters - - - I Croup Bent Under the Body. 

 Lumbo-pubic and Lumbo-iliac Positions. 



Flexed at the Hocks. 



Completely retained. 

 Dorso- lumbar. 

 Sterno-abdominal. 



Limbs 



Head and 

 neck - 



Limbs - 



