. The science and art of midwifery. same reductionneeds to be made as in the normal pelvis, for, though the outward slant of the symphysis CONTRACTED PELVES. 471 surface of the pelvic lateral walls, furnish the prominent points forguidance. Sometimes, when no bony union has formed between thefirst and second sacral vertebrae, a double promontory may be felt. 2. The rachitic form of flattened pelvis presents the followingcharacteristics : The bones are of small size, but usually of normal texture. Some-times, however, they are thin, and even translucent, while in otherinstances they may be unus
. The science and art of midwifery. same reductionneeds to be made as in the normal pelvis, for, though the outward slant of the symphysis CONTRACTED PELVES. 471 surface of the pelvic lateral walls, furnish the prominent points forguidance. Sometimes, when no bony union has formed between thefirst and second sacral vertebrae, a double promontory may be felt. 2. The rachitic form of flattened pelvis presents the followingcharacteristics : The bones are of small size, but usually of normal texture. Some-times, however, they are thin, and even translucent, while in otherinstances they may be unusually compact and thickened. The ilia are flattened, and run in a near-ly horizontal direction. Theanterior superior spinousprocesses flare outward, sothat the distance betweenthem differs little from thatbetween the widest pointsof the crests. The promon-tory projects inward towardthe symphysis pubis. Theupper portion of the sacrumsinks inward between the219.—Flattened rachitic pelvis. (Woods Mu- ilia, and lies farther in front. Fig seum.) of the posterior superiorspinous processes than in the normal pelvis. The upper portion, too,is directed nearly horizontally backward, while the extremity, usuallyat the fourth or fifth sacral vertebra, is bent sharply forward. Theanterior sacral surface loses its transverse concavity, and becomes eitherflat from side to side, or convex from the bulging forward of the sa-cral vertebrae. The antero-posterior shortening of the brim is accom-panied by a compensating increase in the transverse diameter. As,however, the rachitic pelvis is originally undersized, the transversediameter rarely exceeds normal dimensions. The horizontal rami ofthe pubes are flattened, and the acetabula are directed to the cartilage of the symphysis pubis generally projects inward, thepectineal line is often unusually sharp, and at times terminates at theinsertion of the psoas muscle in a projecting spine. Below, the ischiadiverge from one another, and the
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Keywords: ., bookcentury1800, bookdecade1890, bookidsci, booksubjectobstetrics
