472 FCETAL DYSTOKIA. 



CHAPTEE III. 

 Dystokia from Transverse Presentations. 



The foetus is said to be in a transverse position, when the hand of the 

 obstetrist, instead of meeting with the anterior or posterior part of the 

 body, comes in contact with the trunk, either at the shoulders, withers, 

 sides, flanks, haunches, loins, back, sternum or belly, or (which is per- 

 haps most frequent) all of the limbs collected together. The foetus, 

 instead of having its greater axis parallel to the pelvis of the mother, 

 has it transverse, or more or less perpendicular to the antero-posterior 

 diameter of the pelvic canal. 



The possibility of the foetus assuming a transverse position in the 

 uterus has been denied on various occasions by Goubaux, who bases 

 his objections on anatorao-physiological reasoning ; contending that the 

 uterus cannot contain the young creature when so placed, if the various 

 dimensions of the latter be compared with those of the gravid organ. 

 In the first place, however, it must be remembered that the uterus is 

 not an unalterably-shaped body with rigid walls, but a membranous 

 sac whose parietes are soft and yielding ; and that its form may vary 

 with the displacement of its contents — in a word, that its transverse 

 diameter may be increased at the expense of its length. Besides, the 

 foetus itself is not a compact unyielding mass, but is so flexible that it 

 may assume the most varied attitudes and shapes. 



But the strongest proofs in favour of the possibility of such presen- 

 tations are furnished by obstetrical experience — the facts published by 

 a host of observers entirely demolishing the antagonistic theoretical 

 notions. It may be noted, however, that though the presentations are 

 justly designated transverse, yet the body of the foetus is generally a 

 little oblique in one direction or the other. 



Though the transverse vertical or horizontal presentations are not 

 altogether rare, yet they are much less common than the longitudinal 

 presentations, and especially the anterior presentation. They do not 

 appear to be primary, and they are more frequent in the Mare than the 

 Cow — perhaps because of the more energetic contractions of the uterus 

 in the former animal not allowing natural adjustment of the foetus, 

 should the latter not be exactly in a favourable position when labour 

 commences. "When the liquor amnii escapes prematurely, the deviation 

 is still more likely to occur, and particularly if the os is not sufficiently 

 dilated. Torsion of the uterus ; spasm of the cervix ; violent straining 

 and disordered movements of the mother ; deviation of some parts of 

 the foetus — -especially of the head; hydrocephalus, monosomianism, 

 etc., have all been noted at times as a cause of transverse presenta- 

 tions. Deformed head may also lead to this presentation, especially if 

 it is distorted, as in Fig. 103. 



These presentations are essentially dystokial ; as it is evident that 

 the foetus, if of normal size, cannot pass crossways or sideways through 

 the pelvic canal, which barely affords space for its passage longitudin- 

 ally. Birth, therefore, cannot take place without assistance ; version 

 must be practised in order to change the presentation, and one or other 

 of the extremities of the oval mass which the body of the foetus repre- 

 sents must be brought towards the inlet. The malpresentatiou, through 

 hindering birth greatly, endangers the life of the young creature, and 

 especially if it be a Foal. 



