Fig. 2. Thigh and croup presentation, showing the fetus corded. The cord has a ring or noose at one end. The two ends of the cord are pa.s.sed between the thighs, brought out at the flanks, and the plain end pa.s.sed through the noose at the top of the back and brought outside the v.u.l.v.a. The fetus must be pushed back and an attempt made to bring the limbs properly into the genital pa.s.sage.
Fig. 3. Croup and hock presentation. The indications in this abnormal presentation are the same as described for Fig. 2.
Fig. 4. Posterior presentation; the fetus on its back. Turn the fetus so as to make a normal anterior presentation.
Fig. 5. Sterno-abdominal presentation. The fetus is on its side with limbs crossing and presenting. The limbs least eligible for extraction should be forced back into the uterus.
Fig. 6. Dorso-lumbar presentation; the back presenting. The fetus must be turned so that one or the other extremity can enter the pa.s.sage.
PLATE XVIII. Abnormal positions of the calf in utero. Surgical instruments and sutures.
Fig. 1. Twin pregnancy, showing the normal anterior and posterior presentations. (From Fleming.)
Fig. 2. Abdominal dropsy of the fetus; normal presentation; fore limbs corded. (After Armatage.) The drawing ill.u.s.trates the method of puncturing the abdomen through the chest with a long trocar and cannula. The fluid is represented escaping from the cannula after the withdrawal of the trocar.
Fig. 3. Tallich"s short, bent, crotchet forceps. The forceps have bent and toothed jaws, which are intended to take hold of the fetus where neither cords nor hooks can be applied, as the ear, nose, or skin of cheek.
Fig. 4. Clamp for ear, skin, etc.: 1-1, blades with hooks and corresponding holes; 2, ring to close the blades; 3, stem with female screw for handle; 4, handle, which may be either straight or jointed and flexible.
PLATE XIX. Monstrosities. This plate ill.u.s.trates various malformations and diseases of the fetus which act as the cause of difficult parturition.
Figs. 1, 2, 3. Fetuses with portions of their bodies double. Fig. 1 (from Fleming), double head, neck, and fore limbs. Fig. 2 (from Encyclop. der Gesam. Thierheilkunde, 1886), double head, neck, fore limbs, and body. Fig.
3 (from Fleming), double faced.
Fig. 4. Fetus with head very much enlarged. (From Fleming.) This affection is known as hydrocephalus, or dropsy of the brain, and is due to a more or less considerable quant.i.ty of fluid in the cranial cavity of the fetus.
Fig. 5. Skull of the calf represented in Fig. 4. The roof of the skull is absent. (From Fleming.)
PLATE XX. Instruments used in difficult labor.
Fig. 1. Long embryotome with joint.
Fig. 2. Long, sharp hook. This instrument is about 3 feet in length, including the handle. Hooks of this kind, both blunt and sharp, are applied directly to the fetus to a.s.sist in delivery.
Fig. 3. Gunther"s long-handled embryotome. This instrument and that represented in Fig. 1 are of special value in cutting through muscular tissue and in separating the limbs from the trunk when the fetus can not be removed entire. These embryotomes are usually 30 inches long, but may be made either longer or shorter.
Fig. 4. Jointed cord-carrier, used in difficult parturition to carry a cord into regions which can not be reached by the arm.
Fig. 5. Instrument used to rotate or turn the fetus, known as a rotator.
Fig. 6. Dilator of the neck of the womb, used when conception can not take place owing to a contracted condition of the neck of the womb.
Fig. 7. Repeller. An instrument from 2 to 3 feet long, used to force the fetus forward into the womb. This operation is generally necessary when the presentation is abnormal and the fetus has advanced too far into the narrow inlet to the uterus to be moved.
Fig. 8. Cartwright"s bone chisel. Including the handle, this instrument is about 32 inches in length; the chisel portion is a little more than 2 inches long and 1 to 1-1/2 broad. Only the middle portion is sharp, the projecting corners are blunt, and the sides rounded. This instrument is used for slitting up the skin of a limb and as a bone chisel when it is necessary to mutilate the fetus in order to effect delivery.
[Ill.u.s.tration: PLATE XVIII.
ABNORMAL POSITION OF CALF IN UTERO.
SURGICAL INSTRUMENTS AND SUTURES.]
[Ill.u.s.tration: PLATE XIX.
MONSTROSITIES.]
[Ill.u.s.tration: PLATE XX.
INSTRUMENTS USED IN DIFFICULT LABOR.]
[Ill.u.s.tration: PLATE XXI.
INSTRUMENTS USED IN DIFFICULT LABOR.]
PLATE XXI. Instruments used in difficult labor.
Fig. 1. Embryotome, an instrument used when it is necessary to reduce the size of the fetus by cutting away certain parts before birth can be effected. This instrument may be long or short, straight or curved.
Fig. 2. Also an embryotome. The blade can be made to slide out of or into the handle. The instrument can thus be introduced into or withdrawn from the genital pa.s.sage without risk of injury to the mother.
Fig. 3. Schaack"s traction cord. This is merely a cord with a running noose at one end and a piece of wood at the other, to offer a better hold for the hand.
Figs. 4_a_ and 4_b._ Reuff"s head collar for securing the head of the fetus.
Fig. 5. Curved cord-carrier, used in difficult parturition to carry a cord into regions which can not be reached by the arm.
Fig. 6. Blunt hook, used in difficult parturition.
Fig. 7. Short hook forceps, used in difficult parturition.
Fig. 8. Blunt finger hook.
DISEASES FOLLOWING PARTURITION.
By James Law, F. R. C. V. S.,
_Formerly Professor of Veterinary Science, etc., in Cornell University._
FLOODING (BLEEDING FROM THE WOMB).
Though not so common in the cow as in the human female, flooding is sufficiently frequent to demand attention. It may depend on a too rapid calving and a consequent failure of the womb to contract when the calf has been removed. The pregnant womb is extraordinarily rich in blood vessels, especially in large and tortuous veins, which become compressed and almost obliterated under contraction, but remain overfilled and often bleed into the cavity of the womb should no contraction take place. c.o.x records cases in which the labor pains had detached and expelled the fetal membranes, while the calf, owing to large size or wrong presentation, was detained in the womb, and the continued dilatation of the womb in the absence of the fetal membranes led to a flow of blood which acc.u.mulated in clots around the calf. Other causes are laceration of the cotyledons of the womb, or from an antecedent inflammation of the placenta, and the unnatural adhesion of the membranes to the womb, which bleeds when the two are torn apart.
Weakness of the womb from overdistention, as in dropsy, twins, etc., is not without its influence. Finally, eversion of the womb (casting the withers) is an occasional cause of flooding. The trouble is only too evident when the blood flows from the external pa.s.sages in drops or in a fine stream.
When it is retained in the cavity of the womb, however, it may remain unsuspected until it has rendered the animal almost bloodless. The symptoms in such case are paleness of the eyes, nose, mouth, and of the lips of the v.u.l.v.a, a weak, rapid pulse, violent and perhaps loud beating of the heart (palpitations), sunken, staring eyes, coldness of the skin, ears, horns, and limbs, perspiration, weakness in standing, staggering gait, and, finally, inability to rise, and death in convulsions. If these symptoms are seen, the oiled hand should be introduced into the womb, which will be found open and flaccid and containing large blood clots.