QUESTIONS AND ANSWERS 279 



4. Anterior presentation with forward extension of the hind 

 limbs beneath the fetal body. 



Mention two different ways by which the cervix of the uterus may be 

 dilated. 



1. Use of drugs, especially injections of cocaine or stovaine. 



2. Mechanical, either by manual or instrumental methods. 



Mention the signs and the different stages of parturition. 



1. Preliminary stage : Enlargement of mammae ; swelling of the 

 vulva; relaxation of the broad and sacrosciatic ligament. 



2. Dilation of the os uteri : Accompanied by restlessness, labor- 

 pains and presentation of "water-bag." 



3. Expulsion of foetus: Pains more severe and frequent; strain- 

 ing, rupture of "water-bag" and expulsion of foetus. 



4. Expulsion of the membranes. This may occur at birth or soon 

 after. The uterus contracts and the mass comes away. 



Mention some of the causes of dystocia. 



Maternal: Pelvic constriction, uterine inertia, torsion of the 

 uterus. 



Petal: Excess in volume, monstrosities, multiparity, diseases, 

 faulty presentation. 



Name (a) five maternal causes of dystocia, (b) five fetal causes of 

 dystocia. 



(a) Pelvic constriction, uterine inertia, torsion of the uterus, 

 uterine hernia, atresia of the cervix. 



(b) Hydrocephalus, wry-neck, emphysema, double monstrosities, 

 faulty presentation. 



Name two pathologic conditions of the foetus that interfere with par- 

 turition. State how each of these conditions may be over- 

 come. 



1. Hydrocephalus. This consists of a distention of the lateral 

 ventricles of the brain with lymph. In extreme cases, the cranium 

 is distended to two and three times the normal size, and offers a 

 serious obstacle to parturition. Dystocia due to this congenital 

 defect is overcome by puncturing the tumor and breaking down the 

 cranial bones with the chisel. 



2. Wry-neck. This deformity of the foetus is characterized by 

 an abrupt deviation of the head and neck to one side. The cervical 

 portion of the spinal column is bent and the muscles so contracted 

 that the head is held rigidly in this abnormal position. 



To overcome the impediment which this condition offers, ampu- 

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