THE PLACE OF VERSION IN OBSTETRICS By IRVING W. POTTER, M.D., F.A.C.S., OBSTETRICIAN-IN-CHIEF, DEACONESS HOSPITAL AND ST. MARY'S MATERNITY HOSPITAL; WITH 42 ILLUSTRATIONS ST. LOUIS C. V. MOSBY COMPANY 1922 COPYRIGHT, 1922, BY THE C. V. MOSBY COMPANY (All Rights Reserved) (Printed in U. S. A.) Press of The C. V. Mosby Company St. Louis THIS BOOK IS DEDICATED TO THE "WOMAN IN TRAVAIL" IN THE REVERENT HOPE THAT HER "HOUR" MAY BE SHORTENED, HER “ANGUISH” LESSENED, AND HER "JOY" MADE COMPLETE 53448 PREFACE An account of the method of version described in this book, has already been published in several medical and obstetrical journals. It is the result of a gradual evolutionary development on my part, made possible by a large practice in one of the prolific regions of our city, together with association with many midwives who frequently sought my help. Early in my practice version was employed only in complicated cases when it was a choice between a high forceps delivery or a version. Naturally the more I practiced turning the more expert I became. In the beginning I groped around for one foot and then for the other, first with my right hand and then with my left. I very soon gave up exerting pressure over the uterus from above realizing that this was unnecessary as well as being responsible for the arms of the child coming up over the head and other difficulties which I encountered. The more women I delivered, the more satisfied was I with their condition during the whole puerperium, and I found less morbidity and suffering, as the weeks and months went by. I gradually increased the indications and enlarged the field for the version operation and now, I can say that at least ninety per cent of my cases are delivered by version and my last 938 cases had no maternal mortality and a fetal mortality of 2.3 per cent, not counting macerated and dead feti, or babies whose cords did not show any pulsation when delivery was started. The second stage of labor has been eliminated; the women have not suffered any of the pain usually consequent upon this stage; the vagina and perineum have not been subjected to long hours of stretching, which resulted in quick retraction so that relaxed and gaping outlets with protruding and falling bladders and rectoceles did not occur in my patients. Finally, I have been enabled to complete the delivery within an hour and still be fresh and ready for my other work. I wish to thank Dr. Herman E. Hayd of Buffalo, who early |