. An American text-book of obstetrics. For practitioners and students. inger dur-ing the last month, and thecondition is suggestive oflabor begun. But an inneredge may usually be distin-guished (Fig. 170) until theearly labor-pains8 or thethreatening preliminarypains begin. The effect ofsuch early pains in com-mencing the dilatation ofthe cervix in certain cases isshown in Figure 175. In multipara labor is likely to pull back the wholecervix bodily, but with some thinning and with a somewhat irregular the circle widens until it merges imperceptibly into the uterine wall,leaving,
. An American text-book of obstetrics. For practitioners and students. inger dur-ing the last month, and thecondition is suggestive oflabor begun. But an inneredge may usually be distin-guished (Fig. 170) until theearly labor-pains8 or thethreatening preliminarypains begin. The effect ofsuch early pains in com-mencing the dilatation ofthe cervix in certain cases isshown in Figure 175. In multipara labor is likely to pull back the wholecervix bodily, but with some thinning and with a somewhat irregular the circle widens until it merges imperceptibly into the uterine wall,leaving, as a rule, to represent the external os, a slightly raised encircling ringin the wall of the curved birth-tube 3 millimeters (jr inch) in thickness, locatedagainst the back of the symphysis in front and halfway up the sacrum behind(Fig. 134). The wall of the cervix is then 2 millimeters (^ inch) in thick-ness, and the cervix is said to be effaced. The anterior lip may be nipped betweenthe bony ring (pelvis) and the ball of bone (fetal head) and become elongated int. tectum. Vagina. (jgssrgg -~*> Fig. 171—Dilating cervix of eight months primipara, withpronounced thinning of posterior lip (Winter; frozen section,two-thirds natural size). 326 AMERICAN TEXT-BOOK OF OBSTETRICS. and edematous, even to the extent of appearing at the vulva during deliveryor of hanging without it afterward. In patients with contracted inlets theexternal os often remains at or near the brim after full dilatation. The dilatation is estimated either by guessing the coin it seems to resemblein size, or by stating the inches of its diameter, or the number of fingers whichthe elastic ring will admit. The cervix may not be found greatly dilated,and yet may be dilatable to a large size, as determined by the introductionof four fingers or the whole hand. The common error of the beginner is to
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
