EXCESS IN VOLUME OF THE FCETUS. 



375 



1. Extraction of the Foetus entire. — If the " waters " have escaped for 

 any length of time and the parts are dry and viscid, warm emollient fluids 

 should be injected into the vagina, and if necessary the portions of the 

 foetus presenting may be lubricated with glycerine, oil, unsalted lard, or 

 any other lubricant. The hand should then adjust the foetus, if this is 

 requisite, and attempts made to extract it by judicious traction, cords, and 

 other accessory means to be hereafter described, being employed as 

 occasion demands. 



The degree of traction will depend upon the amount of resistance to 

 be overcome ; it being carefully borne in, mind that a medium degree of 

 force well directed is often more effective than severe traction misdirected 

 and inopportune. 



For this reason it is that a careful adjustment of the foetus should be 

 made before any force is resorted to, the " wedged " portions being 

 " eased " and well smeared. It not unfrequently happens that a very 

 trifling displacement of the foetus will allow it to pass gradually through 

 the pelvic canal, and lead to the successful termination of a case which 

 otherwise many would consider impossible to deliver. 



2. Embryotomy. — When forcible extraction is deemed impossible, or 

 dangerous for the mother, and when the latter has ceased to aid in expel- 

 ling the foetus, then the only alternative is embryotomy, which, entailing 

 as it does the destruction of the progeny, yet affords the only chance of 

 saving the parent. The operation will be described hereafter. 



Anomalies In, and Disease of, the Fcetal Membranes. 



It is very rare indeed, so far as published observations are evidence, 

 that anomalies in, or disease of, the foetal membranes prove an obstacle 

 to birth. That they may sometimes do so, however, is evident from what 

 we have previously described. As Franck justly remarks, it is not un- 

 likely that the retention of the foetal membranes after birth is due, in 

 many cases, to inflammation of the placenta (placentitis). A not unfre- 

 quent condition of the membranes is congestion of, or extravasation into, 

 the placenta, rupture of the capillaries {capillary apoplexy), and haemor- 

 rhage between the placenta materna and placenta uterina. Partial sepa- 

 ration of the two placentae is also not very uncommon in the Mare ; and 

 metrorrhagia may be due, at times, to placenta prcBvia. Such haemorrhage, 

 when it occurs in the uterus, and the blood mixes with the uterine milk, 

 gives rise to a chocolate-colored fluid between that organ and the foetal 

 membranes, and in the asphyxia and intra-uterine respiration (pulmonary) 

 of the foetus, this reddish-colored fluid is often present in the lungs. 



Hartmann describes a case in which the chorion papillae of an aborted 

 foal were small, pale, hard, and cartilaginous ; and Broers (Canstatt's 

 yahresbericht, 1861, p. 53) describes two foetuses in the uterus of a Cat, 

 and on the inner surface of the membranes of one were numerous 

 vesicular extravasations, while the other could scarcely be recognized. 

 It may be surmised that many abortions or fcetal deaths are due to dis- 

 ease of the placentas. 



The foetal membranes may be too thick and resisting, or too thin and 

 friable. In the first condition, they resist the labor pains too long, and 

 after the os uteri is completely dilated they may be found intact outside 

 the vulva ; the fcetus may even be expelled in them. Such tenacious 

 membranes may, to a certain extent, hinder delivery, though seldom, if 

 ever, produce dangerous consequences, except to the foetus. 



