A manual of obstetrics . , so that thepressure exerted by the fetus produces separation of thebones: this is most likely to occur at the symphysis pubis,but the sacroiliac synchondroses may also yield. The justomajor, generally equally enlarged {pelvis icqua-bilitcr justomajor^, or giant pekis is one characterized by PRECIPITATE LABOR. 507 an over-size of all its diameters, with, however, preser-vation of the normal proportions. Such a pelvis, unlessvery much above the normal in size, may readily be over-looked. During the progress of gestation in these casesthere is very likely to be a marked
A manual of obstetrics . , so that thepressure exerted by the fetus produces separation of thebones: this is most likely to occur at the symphysis pubis,but the sacroiliac synchondroses may also yield. The justomajor, generally equally enlarged {pelvis icqua-bilitcr justomajor^, or giant pekis is one characterized by PRECIPITATE LABOR. 507 an over-size of all its diameters, with, however, preser-vation of the normal proportions. Such a pelvis, unlessvery much above the normal in size, may readily be over-looked. During the progress of gestation in these casesthere is very likely to be a marked exaggeration in thepressure-symptoms; this follows the extreme descent ofthe uterus into the pelvic cavity, more room being affordedthere for its development than is ordinarily the case; anirritable bladder, obstinate constipation, edema of the vulva,and pronounced varicosities may attend the pregnancy. In a split or inverted (Ahlfeld) pelvis (Fig. 143) the de-formity is usually situated at the symphysis pubis, although. Fig. 143.—Split pelvis (Schauta). more rarely there may exist a congenital fissure of thesacrum and of the lower portion of the vertebral the defect is situated anteriorly, the innominate bones,from the upward pressure of the femora, are rotated outwardand backward, so that there occurs an approximation of theposterior superior iliac spines behind the sacrum, whichbone is also displaced inward to a certain extent; in this waya groove is formed posterior to the sacrum ; hence thename inverted pelvis. Generally the osseous defect is sup-plied by a certain amount of fibrous tissue ; there are oftenassociated other congenital defects, as exstrophy of the blad- 508 A MANUAL OF OBSTETRICS. der. It is rare for conception to occur in this condition,and Klein states that but six such instances are recorded inmedical literature. When the sacrum is cleft a meningoceleoften projects into the pelvic cavity, and this may seriouslyobstruct labor. Diagnosis of P
Size: 1789px × 1397px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
