The American text-book of obstetrics for practitioners and students . 30 AMERICAN TEXT-BOOK OF OBSTETRICS. versa; also, for every centimeter increase in the height of the symphysisover the normal add centimeter to the sum to be subtracted from thediagonal conjugate, and vice versa. While these rules are admirable for thestudy of the dried specimen in a museum, they are not easily applied to theliving pregnant female. The height of the symphysis can be measured in theliving subject, but an allowance for variations in this respect eliminates errorin only a small proportion of cases. The
The American text-book of obstetrics for practitioners and students . 30 AMERICAN TEXT-BOOK OF OBSTETRICS. versa; also, for every centimeter increase in the height of the symphysisover the normal add centimeter to the sum to be subtracted from thediagonal conjugate, and vice versa. While these rules are admirable for thestudy of the dried specimen in a museum, they are not easily applied to theliving pregnant female. The height of the symphysis can be measured in theliving subject, but an allowance for variations in this respect eliminates errorin only a small proportion of cases. The variations in the angle of the sym-physis, a much more important source of error, can only be surmised. Thewriter much prefers the measurement between the upper outer edge of thesymphysis pubis and the promontory of the sacrum for the estimation of thetrue conjugate, having demonstrated its superior accuracy in Fortaking this measurement the patient is put in the dorsal position, with the. Fig. 14.—Hirsts pelvimeter: a, for measuring the true conjugate plus the thickness of the symphysis;b, with extra tip added for measuring the thickness of the symphysis. buttocks projecting beyond the edge of the table or bed on which she mark with the point of a lead pencil is made on the skin over the sym-physis pubis, about ^ of an inch below the upper edge. The two fingers ofthe left hand are inserted in the vagina as in measuring the diagonal conju-gate. The tip of the middle finger, having found the middle line of thepromontory, is moved a little to the patients right, and tip B of the pelvi-meter, shown in Figure 14, is made to take its place. While the examiningphysician holds the shaft of the pelvimeter firmly in place an assistant adjuststip A of the movable bar over the mark made on the symphysis. This bar isthen screwed tight, the whole pelvimeter is removed, and the distance betweenthe tips is found by a tape measure. This distance is the conjugate plus thethi
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