Management of Normal Parturition 547 



In the mare, however, it may generally be considered that, if 

 vigorous expulsive efforts have continued for two or three hours, 

 or if the fetus has been engaged in the pelvis for even a half 

 hour, unless we can observe some definite sign of life, the foal 

 has already perished. 



The death of the fetus, some claim, retards parturition, and 

 the claim is apparently justified by clinical experience. 



The contractions of the uterus upon the living young tend to 

 cause the latter to make spontaneous movements and, in doing so, 

 to extend its extremities in the most favorable position for their 

 passage through the birth canal. If dead, this extension of the 

 limbs is not likely to occur, because of the absence of reflex 

 movements and of the rigidity of the foal. Some authors state 

 that the death of the fetus tends to eliminate a certain stimula- 

 tion to the uterine walls, which causes their contraction, but this 

 is not verified clinicallj' because, as a general rule, we see just as 

 vigorous expulsive efforts in case of a dead fetus as in a living 

 one. Others contend that the contractions of the uterus are not 

 effective upon the dead fetus, because of the flaccid condition of 

 its tissues. 



As previously stated, the position of the fetus prior to birth is 

 essentially different from that which it is expected to assume 

 during its expulsion. Saint-Cyr is correct in holding that, if the 

 dead fetus presents in a proper position, the expulsion is as easy 

 as though the young were alive. Of course, if the fetus has 

 undergone partial decomposition and is emphysematous, its ex- 

 pulsion is very much more difficult. 



SjC , ^ ^ ^i^ 'K "K 



The causes of the death of the fetus during the period of labor 

 may be exceedingly varied. The umbilic cord of the human 

 fetus sometimes becomes knotted, or it may twist about the neck, 

 body or limbs of the child, and thus interrupt the circulation and 

 cause its death. This does not occur in domestic animals with 

 sufiicient frequency to become of clinical importance. The um- 

 bilic cord is too short to favor such an accident. 



Fleming claims that the death of the fetus may be due to the 

 premature rupture of the membranes, the escape of the fetal 

 liquids, and the consequent immediate pressure of the uterus upon 

 the fetus. We do not understand how the pressure of the uterus 



