DYSTOKIA. 61 
Mal-presentation of the Foetus. 
For convenience of description, all presentations 
met with are classified under four heads. These are: 
ist, Anterior. 
2nd, Posterior.. 
3rd, Sterno-abdominal. 
4th, Dorso-lumbar. 
Anterior Presentations. 
VERTEBRO-PUBIC. 
In this case the fcetus is lying on its back, with 
fore-feet up and backwards, and, if long neglected, this 
presentation will most likely terminate in injury to the 
roof of the vulva or vagina. 
If the head and feet have both entered the passage, 
cord the fetlocks, and apply traction in a downward 
direction till the fore-feet are clear of the vulva. As 
soon as the fore-feet have escaped, elevate them, apply- 
ing traction in an upward direction, until the withers 
have entered the pelvic cavity. If the point of the 
withers should catch at the brim of the pelvis, pass in 
the hand, and try, by leverage, to elevate it. It 
sometimes happens, however, that the foetus is firmly 
wedged in the passage, caught at the withers, and no 
amount of traction can extricate it. In this case, the 
foetus must be pushed back into the cavity, by placing 
a repeller (fig. 21) against the tissues, in front of the 
sternum; and when it (the foetus) has entered the cavity, 
this presentation can be transformed into a normal 
one, when delivery can be easily effected. 
