ABNORMAL POSTERIOR PRESEXTATJONS. 



469 



brought into the passage by flexing all the joints on each other. Again 

 pushing the fcetus forward, the same nianci-uvre is repeated with the 

 other hinb, if necessary ; though forced extraction has sometimes suc- 

 ceeded with only one leg in the passage, that which is retained finding 

 space in the abdomen, and even facilitating the passage of the thorax, 

 according to some obstetrists. 



This manipulation is rendered more diflicult than in hock presenta- 

 tion, from the fact that the hocks in this are deeper in the uterus, and 

 jam against the brim of the pelvis, where they cannot be freed by the 

 hand. The difliculty is surmounted by passing a blunt hook round 

 them, or a cord as in Fig. 141, the two ends of this outside the vulva 

 being twisted and drawn upwards and outwards by an assistant ; wliile 

 the operator, pushing at the croup, throws the body of the fci'tus for- 

 ward, and thus allows the point of the calcis to rise above the pelvic 

 brim, when the leg can be extended backward as in hock presentation. 



This method, however, does not succeed in every case ; and when the 



Fig. 113. 

 Thii;h .\Nn Ckovp Prksextatio.v : Thigh conoKn. 



croup is firmly wedged in the pelvic canal and the thighs have cleared 

 the inlet, it is only too often impossible to effect retropulsion. Conse- 

 quently, there are but two courses open — extraction of the foetus in 

 this abnormal position, or removing it by embryotomy. 



Forced extraction of the foetus, without adjustment, is a very serious, 

 because a very violent, measure, and is frequently fatal to the mother, 

 as well as to the offspring. It should, therefore, not be lightly adopted, 

 and every other measure of a milder kind should be tried if it has any 

 probable chance of success. Throwing the motlier on the back or side 

 may eftect a change for the better in the position of the foetus ; or if 

 standing or lying, then raising the hindquarters as high as may be 

 without injury should be tried. 



These faihng, then Lecoq's method may be resorted to. This con- 

 sists in passing the hand, furnished with a cord, between the wall of 

 the pelvis and the body of the foetus as far as the thigh of the latter ; 

 the cord is then pushed beneath the thigh as far as possible and left 

 there, while the hand is passed above — between the leg and body, so 

 as to bring the end of the line up around the stifle and back through 



