Operative Obstetrics Including the Surgery of the Newborn

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In many cases the child dies as the consequence. With other obstetric operations 180 OPERATIVE OBSTETRICS as successful as are now pubiotomy and Cesarean section, unless the child is to be deliberately sacrificed, the forceps should not be ap- plied to the head until engagement and molding have occurred.
If it is proposed to sacrifice the child, craniotomy is safer for the mother than difficult forceps extraction, the head not being engaged.
The operator should know that the pelvis is of suffic
...ient size to permit the passage of the head. Engagement and molding is a prac- tical demonstration of this fact, so far as the upper pelvis is concerned; Fig. 105. — Forceps slipping from the unengaged head (Bumm).
there may be, however, contraction at the pelvic outlet sufficiently great to destroy the life of the child during its exit. Pelvimetry, then, should be practised before forceps extraction and the measure- ment of the outlet included. Pelvimetry should include palpation of the pelvic cavity, as well as measurement by the hand and the pelvimeter.


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