Version (Turning).—Version is a maneuver for altering the presentation of the child while it is still in the uterus. A vertex may be converted into a breech, a breech into a vertex or a transverse into either a vertex or a breech.
Fig. 81.—Version. The child rotates as pressure is made upon the head and traction upon the foot. (Hammerschlag.)
Version usually means that a transverse or a vertex presentation is changed into a breech and is followed by the extraction of the child. The operation is serious and not to be undertaken without definite indications. There is always the risk of sepsis and rupture of the uterus as well as a high probability of a dead child. Perineorrhaphy is, if anything, more frequent after this operation than after forceps.
Fig. 82.—Version is complete when the knee appears at the vulva. (Hammerschlag.)
Preparations.—The room and patient are arranged as for forceps, except that the stirrups can not be put in. The legs must be held by assistants, for the delivery of the after-coming head may be complicated and require the Walcher position, which can not be quickly obtained if the legs are fast. Only eight minutes are allowed for the delivery of the child after the navel passes the vulva, if it is expected to live.
The bladder and rectum must be empty.
Asepsis must be rigid and both subjective and objective.
The dorsal position on a table is imperative.