494 



FOETAL DYSTOKIA. 



The right limb, however, was still an obstacle to birth ; the attempts at extraction had 

 occupied two hours and a half, and the Cow had stood all the time ; now, however, it 

 fell, and the leg of the foetus secured outside the vulva tore away from the pelvis. A 

 strong cord was passed through the left foramen ovale, and the long solid crotchet was 

 inserted in the loins, towards the thirteenth rib ; while another smaller hook was fixed in 

 front of the pubis. By these means an enormous, but well-formed calf, was soon brought 

 away. 



With careful subsequent treatment, the Cow quite recovered. 



4. Wernert [Bulletin de la Soc. Centrale de Med. Veteriiiaire, 1877, P- 74) reports the 

 case of a Cow which, during the later period of pregnancy especially, had the belly so 

 large that it was supposed to have twins. The foetus could be seen moving at the left 

 and right flank, but when the period of gestation had expired an accident caused its 

 death. Parturition commenced, but the efforts were not vigorous ; the position of the 

 foetus could not be ascertained by the farm people. The Cow lay on its left side, and 

 Wernert, exploring the vagina and uterus, found only the back of the calf ; to the right, 

 at the level of the ilium, the tail and buttock were discovered, and to the left, on the 

 same level, the withers and ridge of the neck. Neither feet nor head could be reached, 

 nor yet the elbows or hocks ; the umbilical cord was not to be found. Mutation upwards 

 was attempted, with a view to placing the foetus on its belly ; with great difficulty a knee 

 was seized, and this was secured by a cord. Pushing on the spine with the right hand, 

 and pulling at the same time with the left hand on the fixed limb, the operator contrived 

 to effect a slight version, which allowed him to get hold of another foot by the claws. 

 Exhausted by his efforts, Wernert was obliged to desist for half-an-hour. At this period 

 a hind and fore-limb had been brought into the passage ; beyond, in front of, and across 

 the pelvis, were a haunch, the back, and the withers. Resuming his efforts, the secured 

 limbs were strongly pulled at, and exploration discovered the other knee and the second 

 hock accessible to the hand ; these were flexed and brought into the vagina. In this 

 new position the calf had executed a complete half-turn forward and upward: from the 

 left side, the limbs in front, it was placed on the right side with the limbs behind, the 

 tail being still to the right and withers to the left. At this moment, and for the first 

 time, the head could be felt beneath the belly of the calf, the neck being bent between 

 the limbs and resting on the sternum. The cord was taken off the hind-limb and fixed 

 on the second fore-leg ; the hind-limbs were bent and pushed back as far as possible 

 into the uterus ; the neck was straightened, the head properly placed, and the lower jaw 

 corded. Powerful traction then brought away the calf, which was very large and much 

 swollen by infiltration, presenting, as it did, evidences of advanced decomposition. The 

 Cow died the following day ; though the cause of death is not mentioned. 



Dystokia from the Sterno-abdominal Presentation. 



The sterno-abdominal presentation is a rather common one, particularly 

 in the Mare. The foetus is lying on its side, with the sterno-abdominal 

 region and crossed limbs — either flexed or extended — presenting at the 

 inlet or engaged in the passage, while the dorsal region is towards the 

 fundus of the uterus. 



There is no difficulty in discovering this malpresentation, the hand 

 encountering the feet — usually all four — in the uterus, and generally two 

 or more of them in the canal. Nevertheless, as we have two positions in 

 the presentation, it is necessary to distinguish which of them we may 

 have to deal with. The situation of the head, of course, defines the 

 position ; so that we may have a rig/il cephalo-ilial, in which the foetus is 

 lying on its left side, the head directed towards the right flank of. the 

 mother ; and a left cephalo-ilial, the reverse of the preceding. In the 

 majority of cases, either the hind or the fore part of the body is nearest 

 the inlet ; so that the limbs belonging to one part are more advanced 

 than those of the other. When the head can be felt there is, of course, 

 no difficulty in distinguishing the position, but generally the head is 

 beyond reach. 



Then the position must be ascertained by a careful examination of the 

 limbs^ before any attempt at mutation is made ; and in this we have to 

 distinguish between the fore and the hind-legs, as these alone can inform 



