Identifier: textbookofpracti00granuoft (find matches)
Title: A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery
Year: 1897 (1890s)
Authors: Grandin, Egbert H
Subjects: Obstetrics
Publisher: Philadelphia, Davis
Contributing Library: Gerstein - University of Toronto
Digitizing Sponsor: MSN

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remember, therefore, are that extension must bedelayed until the suboccipital point has become fixed underthe pubes, and that then, and only then, extension after agradual fashion should be allowed. (Plates XXVIII andXXIX.) The teaching of support of the perineum hasbeen of great harm as regards the maintenance of the integrityof the maternal soft parts. It is not the perineum which needssupport. It is the head which must be delayed in its progressuntil the muscular structures have relaxed, as they inevitablymust unless diseased, and extension must be prevented until theproper diameter of the head has engaged at the outlet underthe pubic arch. If anything is to be supported it is thefcetal head, and the support given is in the line indicated. Inthe normal case the perineum need not be touched. Referenceto the plate shows how the thumb of the attendant is delayingadvance and, at the same time, promoting flexion until thestructures have yielded and until the suboccipital point is > X
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X PH

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