The practice of obstetrics, designed for the use of students and practitioners of medicine . overdevelopment of the anteriorportion of the lower segment.*This form of deviation is verycommon (Fig. 803). Anterior andlateral deviations are produced ina similar manner, but are of -muchmore rare occurrence (Fig. 804).Symptoms: As in all dystocicanomalies of the cervix, most ofour information is obtained fromtouch, confirmed in certain casesby the result of palpation of theuterus through the abdominal wall.^The vaginal touch, which shouldalways take account of the culs-de-sac, finds one effaced and
The practice of obstetrics, designed for the use of students and practitioners of medicine . overdevelopment of the anteriorportion of the lower segment.*This form of deviation is verycommon (Fig. 803). Anterior andlateral deviations are produced ina similar manner, but are of -muchmore rare occurrence (Fig. 804).Symptoms: As in all dystocicanomalies of the cervix, most ofour information is obtained fromtouch, confirmed in certain casesby the result of palpation of theuterus through the abdominal wall.^The vaginal touch, which shouldalways take account of the culs-de-sac, finds one effaced and the other of unduedepth. In backward deviation the fetal head is often found engaged and almostupon the pelvic floor. The cervix looks directly backward upon the sacrum, ata height which varies in individual cases, and which may attain the promontory. * Sacciform dilatation of the. anterior portion of the lower uterine segment. Fig. 803.—Backward Deviation or Malposi-tion OF THE Os. Sacciform dilatation of theanterior portion of the lower uterine frequent occurrence. CetvIk. Fig. 804.—Anterior Deviation or MalposiTiON of the Os. a Rare Anomaly. MATERNAL DYSTOCIA FROM OBSTRUCTED LABOR. 609 It may be difficult in the latter case to feel the os at all (Fig. 803). In anteriordeviation the conditions are reversed. The os looks toward the upper part of thesymphysis, and it may be impossible to reach it with the finger, unless thepatient is first placed in the genupectoral position. (See Posture, Part X.)Analogous symptoms are present in lateral deviation. Diagnosis : If the prac-titioner cannot locate the os, he may conclude erroneously that he is dealingwith imperforation of the cervix, or that the latter has become completelyeffaced by dilatation. It has happened that the inexperienced have sought toapply forceps under the latter misapprehension. In order to make a differentialdiagnosis it is sometimes justifiable to rupture the membranes. I urge that thepatient be
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
