. An American text-book of obstetrics. For practitioners and students. o the same child. The most conclusive evidence ofdouble fetation is the detection at the same time of two fetal heart-beats ofdifferent rates. Palpation in multiple pregnancy is generally rendered difficult by the per-manent tension of the uterine tumor. 358 AMERICAN TEXT-BOOK OF OBSTETRICS. 2. External Measurements of the Pelvis. In priiniparse, and in multipara? in whom the previous obstetric historygives rise to any suspicion of pelvic contraction, the external diameters of thepelvis should be measured. Three measurement
. An American text-book of obstetrics. For practitioners and students. o the same child. The most conclusive evidence ofdouble fetation is the detection at the same time of two fetal heart-beats ofdifferent rates. Palpation in multiple pregnancy is generally rendered difficult by the per-manent tension of the uterine tumor. 358 AMERICAN TEXT-BOOK OF OBSTETRICS. 2. External Measurements of the Pelvis. In priiniparse, and in multipara? in whom the previous obstetric historygives rise to any suspicion of pelvic contraction, the external diameters of thepelvis should be measured. Three measurements are usually sufficient—namely, the external conjugate, the interspinal, and the intercristal. Of these measurements the most important is the external conjugate (). This diameter is measured from the depression (Fig. 19-1) just belowthe spine of the last lumbar vertebra to a point on the pubic surface in frontof the upper part of the symphysis. As a rule, it may safely be assumedthat the pelvis is ample when this diameter exceeds 1\ inches (18 centimeters),. PromontoryFig. 195.—Manual method of measuring the diagonal conjugate. and that it is contracted at the brim when the diameter falls below that the sacro-pubic diameter at the brim will be found shortened withan external conjugate of 1h inches (19 centimeters), and it may be normalwhen the diameter of Baudelocque is less than 7\ inches (18 centimeters).Contraction in other diameters must be excluded. An interspinal equal to or greater than the intercristal diameter indicatesflattening of the pelvis; when both are small, there is general contraction. 3. Vaginal examining per vaginam the obstetricians hands and the externalgenitals of the patient are to be cleansed with the same care that is observedduring labor. CONDUCT OF NORMAL LABOR, Plate 25.
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
