A system of obstetrics . not coincide with the axis of the parturient canal, and thepresenting part, under the influence of uterine contractions, drives the 1 Arch. Tocol, 1876. 2 Loc. cit, p. 265. s Loc. eit., p. 262. 4 Volkmanns Sammlunn klin. Vortr., 1879, No. 170. 5 Trans. Ninth International Medical Congress, 1887. DISPLACEMENTS OF THE GRAVID WOMB. 4(55 posterior diverticulum downward against the pelvic floor and at this time spontaneous elevation of the pouch occupying thepelvic cavitv may occur under powerful labor-pains prolonged througha considerable period of time and t
A system of obstetrics . not coincide with the axis of the parturient canal, and thepresenting part, under the influence of uterine contractions, drives the 1 Arch. Tocol, 1876. 2 Loc. cit, p. 265. s Loc. eit., p. 262. 4 Volkmanns Sammlunn klin. Vortr., 1879, No. 170. 5 Trans. Ninth International Medical Congress, 1887. DISPLACEMENTS OF THE GRAVID WOMB. 4(55 posterior diverticulum downward against the pelvic floor and at this time spontaneous elevation of the pouch occupying thepelvic cavitv may occur under powerful labor-pains prolonged througha considerable period of time and the normal retraction of the loweruterine segment. In other cases the postero-inferior segment of theuterus may be ruptured, or labor comes to a standstill with the usualfatal consequences unless timely assistance is rendered. The attach-ment of the placenta to the portion of the uterine parenchyma containedwithin the pelvis is an additional source of danger; the organ usuallyrequires manual extraction (Crede). Fig. Retroflexion of the Gravid Uterus—Exfoliation of the Vesical Mucous Membrane (Schatz). DIAGNOSIS.—The recognition of partial retroflexion and sacciformdilatation of the posterior uterine wall commonly involves no especialdifficulty when the half hand is introduced into the vagina. Conglu-tination1 of the external os may in exceptional cases closely simulatethe conditions under consideration. However, the cervix can always 1 Depaul committed this error in diagnosis (Obs. II.). lie was unable to find theos uteri in a case of labor, and made an incision through what subsequently provedto be the postero-inferior uterine segment. The patient died with the foetus in I.—30 466 THE PATHOLOGY OF PREGNANCY. be discovered in partial retroflexion after a careful search; and thisfinding is sufficient to clear up all obscurity in diagnosis. It is never easy, and frequently impossible, to distinguish betweenpartial retroflexion and sacciform dilatation of the
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