The practice of obstetrics, designed for the use of students and practitioners of medicine . the hy-giene of pregnancy and the procur-ing of the mothers, babys, and ob-stetric outfit. (See Part IV.) Primi-gravidae should have their pelvesmeasured before the twenty-eighthweek; the spines, crests, trochanters, external and internal conjugates, being measured as matters of routine. Shouldpelvic deformity exist, more exhaustive measurements should be taken, and ifnecessary we should not hesitate to make an internal examination under nitrousoxide, chloroform, or ether. A comparison should be made b
The practice of obstetrics, designed for the use of students and practitioners of medicine . the hy-giene of pregnancy and the procur-ing of the mothers, babys, and ob-stetric outfit. (See Part IV.) Primi-gravidae should have their pelvesmeasured before the twenty-eighthweek; the spines, crests, trochanters, external and internal conjugates, being measured as matters of routine. Shouldpelvic deformity exist, more exhaustive measurements should be taken, and ifnecessary we should not hesitate to make an internal examination under nitrousoxide, chloroform, or ether. A comparison should be made between these measure-ments and the weight and height of the patient, and her husband, and their patients skeleton should be considered as to its character; one composedof light bones has generally a relatively large pelvic girth, while the conversealso holds true. If the patient be a multigravida, all of these careful measure-ments are not necessary in private practice, if the previous children have beenof usual size and the labors uneventful. However, the size of the fetal head. Fig. 193.—Opened Vulva in a Primigravida;Thirty-eighth Week; Shallow VulvalCanal.— {From a photograph at the New YorkMaternity.) 154 PHYSIOLOGICAL PREGNANCY. should be estimated two weeks before labor is expected, in order to detect anyovergrowth of the fetus. (See Cephalometry.) The examination of pregnancycan conveniently be divided into (i) external or abdominal, and (2) internal orvaginal. EXTERNAL OR ABDOMINAL EXAMINATION. DIAGNOSIS OF FETALPRESENTATION, POSITION, AND ENGAGEMENT OF PRE-SENTING PART. EXTERNAL PELVIMETRY. The patient should lie upon her back upon the side of the bed or couch,with the clothing loosened and the abdomen bare, or covered only with onethickness of a bed-sheet, through which it is possible to make a satisfactoryexamination. The examiner should see that his hands are warm, since the
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
