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354                                              MEDICAL JTJEISPRUBENCE

uterine contractions may be so powerful as to fracture the cranial bones of
the fcetus.

Cater records the case of a woman, aged 32, who expected her first delivery about
December 24, 1901. A month before the anticipated event there was haemorrhage per
vaginam following a " very bad dream ", the patient leaving her bed during sleep. The
child was then living and occupied the left dorso- anterior transverse position. l*be
external os barely admitted the finger tip. The haamorrhage ceased within forty-eight
hours On the 6th December labour pains commenced at 11 a.m. At 5 p.m. the doctor
on his arrival found that the child was born and lying in its back with both legs and
thighs flexed, the feet resting against the mother's left buttock. The cord was almost
black and without pulsation, but there was no discoloration about the body. The eyes
and tongue protruded, the head presenting the appearance of craniotomy forceps having
been employed. The frontal bone was fractured, the fracture extending from above the
left orbit to the right malar bone. The occipital bone was fractured into two unequal
pieces. The child was full-term and weighed 6J Ibs. There was no such pelvic defor-
mity as to be responsible for the crushing of the child's head.11

5. Death of the Mother. — When the mother dies in the act of delivery,
the question arises as to how long a child may live in utero after her death.
The time depends upon the cause of the mother's death. If ,4§ath occurs
slowly from haemorrhage, there is very little chance of saving the child, but
it may be saved if an attempt is made to extract it soon after the sudden
death of the mother from some accident, if she was previously in good
health. Rosin 12 reports a case in which he delivered a full-time male child,
weighing 7| pounds, "by Csesarian section in a state of asphyxia livida
a quarter of an hour after the mother's death. Twenty minutes3 artificial
respiration and alternate immersions in hot and cold baths revived the child,
who cried lustily. Dixon Hughes13 mentions a case in which a live child,
weighing 9 pounds and 4 ounces, was delivered by forceps 9 to 10 minutes
after the sudden death of the mother. A case is also recorded where twins
were delivered by Caesarian section 5 minutes after the death of a Chinese
woman, aged 38 years.14

After Birth, — X^^JSaxfibcajtio]^^             may die from suffocation after

birtfc,' If it is born under a caul, i.e. with membranes over the head thus
covering the mouth and nostrils. The child may also die from suffocation,
if its face is pressed accidentally in the clothes or submerged accidentally in
the discharges, such as blood, liquor amnii or meconium.

2. Pt^ipitate Labour.— In precipitate labour a child may be born
wiffiout the mother's kncJwTSge and may die from suffocation by falling
accidentally into a privy pan containing faeces, or from drowning by falling
into a chamber pot containing urine, fi the woman is standing erect at the
time, the child may be forcibly shot down from her genital canal, and may
die from fracture of the skull caused by a fall on a hard floor. Ordinarily,
a drop of thirty inches which is the average distance of the female genitals
from the ground in the erect posture is sufficient to cause fracture of the
sbiH bones, but a fall of eighteen inches may fracture them as well. In
such a case the child is small as compared with the size of the pelvis of IB?8*
mother and one or both parietal bones may be fractured ; in some cases the
fracture may radiate into the frontal, and squamous portion of the temporal
belie. Mud, sand or gravel may be found in the hair or injured scalp of the
child, if the floor is covered with such material. The cord is either torn
across, or the placenta is expelled with the child. Haemorrhage from the
torn cord, as a rule, stops owing to the contraction of the muscular wall of

11, ,$nL Med. Jotm, May 17, 1902, p. 1207.

!&  I^ei, April 16, 1927, p. 820 ; see also Joyce Morgan, Lancet, Aug. 3, 1940, p. m

B. HA Jcmr. Ausfarl, Oct 2» 1943, Vol. 30, p. 264 ; Med.~Leg. and Criminal Rev^ Vbl
mj%J m feu* JL m; see also KfeaM Nafl, Lancet, April 24, 1948, p. 654; Walter
«B* Hsfews, Brit Me& Jtomr«» ApS 22, B50, p. 938 ; Kronick, M., New £ug. J.
I>ee, 14, 1950, p. 953.

14  W. C^m Sgam, B^t JfeeL Jotttv, Sep. 1, 1951, p. 546.