DYSTOKIA FROM MALPRESENTATION OF FCETUS. 



437 



well placed — from the pelvic inlet, the hand and fore-arm are introduced 

 in supinaticm and well forward between the body of the young creature 

 and the floor of the uterus ; then resting the arm on the pubis, it is em- 

 ployed as a lever in raising and turning the part of the foetus in hand to 

 the right or left, as may be. If the young creature is nlive, this manoeu- 

 vre is much more easily executed than when it is dead, as it seconds the 

 effert. BoutroUe advises that the abdomen of the mother be raised by 

 means of a girth or folded blanket, while rotation is being effected ; and 

 other authorities have recommended the employment of a lever between 

 the foetus and the uterus to effect this turning. Rainard recommends, 

 when the limbs are in the pelvis, to tie them together, draw them beyond 

 the vulva, put a piece of stick or any oth^r convenient article between 

 them, and to use this as a kind of lever to turn the body of the foetus 

 round to the necessary extent ; or, which is preferable, as in the latter 

 operation the limbs of the young animal may be seriously injured, to give 

 the limbs to an assistant who, acting under instructions from the opera- 

 tor, turns them one over the other in a kind of twisting and swinging 

 manner, in the direction indicated by the operator, whose efforts are in 

 this way greatly assisted. 



The operation of rotation is completed when the greatest diameter of 

 the foetus is coincident with the sacro-pubic diameter of the pelvic inlet 

 — a right or left vertebro-ilial position, for example, being transformed 

 into a vertebro-sacral position. 



Saint-Cyr points out that this modification need not always be so com- 

 plete, and that it frequently suffices to convert a lateral position into an 

 oblique one, by making the dorso-sternal diameter of the foetus correspond 

 to the oblique diameter of the inlet — measuring this from the supra- 

 cotyloid crest of one side to the sacro-iliac articulation of the other. The 

 same observation is applicable to posterior presentations. 



Version. — " Version," or *' turning," in veterinary obstetrics signifies 

 effecting a change of presentatio7i, or, in other Avords, bringing towards the 

 inlet a part of the foetus other than that which presented spontaneously, 

 and thus correcting a faulty presentation. 



A longitudinal presentation is that in which spontaneous birth can be 

 alone effected ; a transverse presentation renders birth impossible, and 

 these, consequently, give rise to dystokia. Version is therefore indicated 

 in all transverse presentations, no matter what region of the body may 

 first offer at the pelvic inlet j it may even be required in certain forms of 

 anterior or posterior presentation ; and in all cases it is necessary to 

 repel the presenting part, so as to bring one or other of the ends of the 

 oval mass formed by the body of the foetus to the pelvic inlet. 



Hence we have two kinds of version : one which has for its object the 

 movement of the head of the foetus towards the pelvic inlet — anterior or 

 cephalic version ; and the other the posterior part of the body to the 

 same opening — posterior or pelvic version, corresponding to the podalic 

 version in human obstetrics. Each of these versions has its advantages 

 and disadvantages, according to circumstances ; though the majority of 

 authorities ^xoi^x pelvic version, for the simple reason that with this there 

 are only two appendages to care for — the hind limbs, to which it is com- 

 paratively easy to give a good direction ; while in cephalic version there 

 are not only the fore limbs to attend to, but also the head and neck, the 

 unfavorable direction of which may give rise to much trouble in delivery. 



