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August 13, 1887

THE MANAGEMENT OF OCCIPITO-POSTERIOR POSTIONS.Read in the Section on Obstetrics and Diseases of Women, at the Thirty-Eighth Annual Meeting of the American Medical Association, June, 1887.

Author Affiliations


JAMA. 1887;IX(7):193-196. doi:10.1001/jama.1887.02400060001001

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I shall premise my remarks by stating the well estabilshed obstetrical fact, that in 20 labors, the vertex presents 19 times. The great Naegelé has demonstrated that in about one third of the cases of presentation of the vertex, the occiput was found in the posterior part of the pelvis, and in this position oftenest at the right posterior sacro iliac synchondrosis; occasionally it is found placed at the left sacro-iliac joint, or in the hollow of the sacrum; and to sum up, the occiput is found seventy times at the left anteriorly, and twenty-seven times at the left anteriorly, and twenty-seven times at the right posteriorly; the other varieties of position being very rare. This opinion has been adopted by most authorities in midwifery. Seeing the frequency of this position, it is of the utmost importance to the accoucheur to study its mechanism and treatment.

Causes.—The chief condition of

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