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A textbook of obstetrics . - is explained by the fact that the presentingpart impinges directly upon the middle of the pelvic floor as itdescends the birth-canal, instead of being directed forward to thevulvar orifice Fistulas of tin- anterior vaginal wall are likewisecommon, from the localized pressure to which this region issubjected while the head is passing the obstruction at the inlet. ANOMALIES TN THE FORCES OF LABOR. 465 The presenting part is thrown forward by the projecting ver-tebrae, and is received upon the prominent ridge of the pubichone, greater in height and higher in situation
A textbook of obstetrics . - is explained by the fact that the presentingpart impinges directly upon the middle of the pelvic floor as itdescends the birth-canal, instead of being directed forward to thevulvar orifice Fistulas of tin- anterior vaginal wall are likewisecommon, from the localized pressure to which this region issubjected while the head is passing the obstruction at the inlet. ANOMALIES TN THE FORCES OF LABOR. 465 The presenting part is thrown forward by the projecting ver-tebrae, and is received upon the prominent ridge of the pubichone, greater in height and higher in situation than in the nor-mal pelvis. Treatment of Labor Obstructed by Spondylolisthetic Pelvis.—The management of labor in these cases is governed by the sameprinciples that obtain in the management of labor in a flat the effective conjugate is over em., the woman can bedelivered spontaneously, by forceps, or by version. With aneffective conjugate of between 7 and cm., the induction ol. Fig. 329.—Angulation of the spine in kyphosis. premature labor and the performance of symphysiotomy mustbe considered ; or craniotomy should be done if the child isdead. If the effective conjugate is well under 7 cm., deliverymust be effected by a Cesarean section. These rules presuppose,of course, a child of average size. Kyphosis.— The kyphotic pelvis was first adequately de-scribed in [865 by Breisky, although its peculiarities had beenrecognized before- by Litzmann in 1861 and by Neugebauer in[863. The condition was called by Herrgott spodylizema,a name adopted by Neugebauer and others (Figs. 330, 331}.30 466 THE PATHOLOGY OF LABOR. Characteristics.— The degree of deformity in a kyphotic pel-vis depends upon the situation of the hump : the nearer this isto the sacrum, as a rule, the greater is the deformity in thepelvis. Lumbosacral kyphosis is almost as frequent as thelumbar and dorsolumbar combined. There is a compensatinglordosis of the lumbar spine, but not enough to ke
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Keywords: ., bookcentury1800, bookdecade1890, bookidtex, booksubjectobstetrics