OBSTETRICS 229 



or not, and this must be decided at the onset of 

 labor or after the preliminary examination. There 

 are two courses open to the surgeon, one to endeavor 

 to extract the fetus after crushing the head or per- 

 forming embryotomy; the other, which gives by far 

 the best results if done early enough, is cesarean 

 section. This operation, if performed before the 

 mother is moribund or septic infection has taken 

 place, is justified by its success. The puppies in 

 any event are savec!; and the mother is given her 

 only chance for life. It is as well to remove the 

 ovaries at the time of cesarean section and thus 

 effectually prevent a recurrence of the trouble. 



2. Rigid pelvis. — In old bitches that have been 

 kept from breeding until late in life relaxation of 

 the pelvic ligaments and consequent dilatation does 

 not take place as readily as in the young animal, 

 hence difficulty in delivery is often experienced. The 

 indications for management are the same as for the 

 foregoing. 



3. Constrictions of the vagina. — This condition 

 arises from^ cicatricial contractions after injuries to 

 the vaginal mucous membrane, usually incurred 

 either during a previous parturition or as a result of 

 operations for the removal of new growths or ab- 

 scesses. It often is a serious and sometimes an in- 

 surmountable obstacle to delivery and may necessi- 

 tate cesarean section. Before resorting to this, 

 however, a cautious effort should be made to dilate 

 the passage either with the fingers or with a trivalve 

 speculurh ; or one may even try incising it, if its 

 situation and extent warrant such a procedure. In 

 many cases, however, the fetus may be extracted, 

 after thorough lubrication with sterile vaselin or 

 olive oil, by means of the forceps and traction 

 cautiously applied. 



4. New growths of the os, cervix, and vagina. — 



