A textbook of obstetrics . epelves withadouble promontory, the conjugate from thetrue promontory Longer in four and shorter in three cases than the conjugate measuredfrom the false promontory. In two cases the two conjugates were t equal Length(Klin Vbrtrage ttbei Geburtshiilfe, Berlin, 1853). ANOMALIES IN THE FORCES OF LABOR. 4-^5 above the superior strait, resting on one iliac bone or on thesymphysis, or it may be pressed down firmly upon the brim in atransverse position, to accommodate its longest diameter to thelongest diameter of the pelvic inlet. Malpresentations are com-mon, as is also
A textbook of obstetrics . epelves withadouble promontory, the conjugate from thetrue promontory Longer in four and shorter in three cases than the conjugate measuredfrom the false promontory. In two cases the two conjugates were t equal Length(Klin Vbrtrage ttbei Geburtshiilfe, Berlin, 1853). ANOMALIES IN THE FORCES OF LABOR. 4-^5 above the superior strait, resting on one iliac bone or on thesymphysis, or it may be pressed down firmly upon the brim in atransverse position, to accommodate its longest diameter to thelongest diameter of the pelvic inlet. Malpresentations are com-mon, as is also prolapse of the cord and of the membranes may protrude in a cylindrical pouch from theexternal os as the liquor amnii is forced out of the uterus withoutobstruction from the imperfectly engaged head. From the samecause an early rupture of the membranes is likely. Accordingto Litzmann, natural forces end the labor in seventy-nine percent, of cases, but in fifty per cent, the head is not fully engaged. Fig. 283.—The two conjugates of a double promontory: Prom., true promontory;F. P., false promontory (Ribemont-Dessaignes). until the os is completely dilated. The dilatation of the os pro-ceeds slowly, for the head does not descend low enough to pressupon the cervix. Consequently the dilatation must be effectedby a retraction of the cervix over the head or by the distendedmembranes. Should the latter rupture, the os, although consider-ably dilated, may retract until the head at length descends andagain dilates it. After the obstruction at the superior strait ispassed,—where, of course, it is greatest,—the head usually de-scends the remainder of the birth-canal with ease and rapidity,but labor may be prolonged by an exhaustion o( the natural forcesin the attempt to secure engagement. The apparent anomalies in 426 THE PATHOLOGY OF LABOR. the mechanism of labor characteristic of this deformed pelvis arein reality the best possible provision for the spontaneous ob
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
