A textbook of obstetrics . taneous delivery may be ANOMALIES IN THE FORCES OF LABOR 47 possible, though it may be necessary to use forceps. Below the forceps may be tried cautiously, but symphysiotomy islikely to be required. In no other form of contracted pelvis isthis operation so successful. Klein found, by experiments on thecadaver, that by a separation of the symphysis to 6 cm. in akyphotic pelvis, the tuberosities moved cm. further , therefore, might be expected to be successfulin a transverse diameter of 6 cm. or even a trifle less. If the childis dead or i
A textbook of obstetrics . taneous delivery may be ANOMALIES IN THE FORCES OF LABOR 47 possible, though it may be necessary to use forceps. Below the forceps may be tried cautiously, but symphysiotomy islikely to be required. In no other form of contracted pelvis isthis operation so successful. Klein found, by experiments on thecadaver, that by a separation of the symphysis to 6 cm. in akyphotic pelvis, the tuberosities moved cm. further , therefore, might be expected to be successfulin a transverse diameter of 6 cm. or even a trifle less. If the childis dead or if the graver obstetrical operations are not admissible,craniotomy should be performed, in case the forceps fail. Inemploying forceps the operator must remember the dangers ofrupture of the symphysis and deep tears of the vaginal walls towhich kyphotic subjects are particularly liable. Version hasgiven the worst results of all the obstetrical operations in kyphoticpelves. It is, therefore, as a rule, contraindicated. Kleins. Fig. 338.—Asymmetrical contraction of the outlet from kyphoscoliosis. statistics show that in fifty-eight to sixty per cent, of cases thelabor must be terminated by operative interference. Diagnosis.—The diagnosis of a kyphotic pelvis presents nodifficulties. The hump-back is obvious, and the history is easilyobtained that the spinal deformity was developed early in pelvic measurements diagnostic of this deformity show anincreased separation of the iliac crests and the anterior spines, anabnormally long conjugate diameter of the inlet, a diminisheddistance between the posterior superior spines, an approximationof the tuberosities of the ischiatic bones, and some diminution inthe anteroposterior diameter of the pelvic outlet. The buttocksare flat and pointed below, the external genitalia are displacedforward and upward, and the upper edge of the symphysis isabove the upper edge of the pubic hair. Care should always beexercised to detect asymmetry
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics
