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December 8, 1951

MANAGEMENT OF ABNORMAL PRESENTATION DURING SECOND STAGE OF LABOR

Author Affiliations

Pittsfield, Mass.

JAMA. 1951;147(15):1404-1406. doi:10.1001/jama.1951.03670320004002
Abstract

In recent years there have been few radical changes in the management of abnormal presentation during the second stage of labor. But it behooves us all to review our results periodically and to attempt to improve our fetal salvage. This may often be accomplished by emphasizing such commonly accepted procedures as sterile vaginal examination during labor or frequent auscultation of the fetal heart. Many hospitals require obstetric consultation for prolonged or complicated labor, such as those with abnormal presentation. A good physician, whether a specialist or general practitioner, should not hesitate to consult another physician.

GENERAL CONSIDERATIONS 

Etiology.  —Though there are numerous causes of abnormal presentation, the commonest are the following: cephalopelvic disproportion, relaxed musculature of the multipara, prematurity, placenta previa, congenital anomalies, twin pregnancy, and pelvic mass. Frequently no definite cause can be found, and yet abnormal presentation may recur with a subsequent pregnancy.

Diagnosis.  —Though the diagnosis of

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