The practice of obstetrics, designed for the use of students and practitioners of medicine . FiG. 209.—Digital Method of Measuring the Diagonal Conjugate of the Pelvic Inlet.—(From a photograph.) 170 PHYSIOLOGICAL PREGNANCY. diagonal conjugate, by constructing a triangle formed by the two conjugatesand the symphysis pubis, of which the diagonal conjugate correspondsnearly to the hypothenuse, and the true conjugate to the base. The diagonalconjugate, the known quantity, is the longest of the three sides, and the trueconjugate, the unknown quantity, can be obtained from it by subtracting onan av
The practice of obstetrics, designed for the use of students and practitioners of medicine . FiG. 209.—Digital Method of Measuring the Diagonal Conjugate of the Pelvic Inlet.—(From a photograph.) 170 PHYSIOLOGICAL PREGNANCY. diagonal conjugate, by constructing a triangle formed by the two conjugatesand the symphysis pubis, of which the diagonal conjugate correspondsnearly to the hypothenuse, and the true conjugate to the base. The diagonalconjugate, the known quantity, is the longest of the three sides, and the trueconjugate, the unknown quantity, can be obtained from it by subtracting onan average i inch ( cm.). The amount to be deducted, however, will varywith the height, thickness, and inclination of the symphysis and the height ofthe sacral promontory. When the symphysis is i-| inches ( cm.) or over,f inch ( cm.) should be subtracted from the diagonal conjugate; and whenit is less than 1^ inches ( cm.), a little less is to be subtracted. The esti-. FiG. 210,—Method of Measuring the Transverse Diameter of the Pelvic points of the pelvimeter are placed on the palmar surfaces of the tips of the index-fingers. See diagram, upper left of illustration.—{From a photograph.) mation of the true conjugate by this plan can only be approximated, since itdepends upon so many variable quantities. The method of taking the heightof the symphysis is described on page 166. For determining the thickness ofthe symphysis the pelvimeter of Skutsch, or one of its modifications, may beused (Fig. 215). It can be roughly estimated, of course, by the thumb andfinger of the accoucheur (Fig. 213). The normal angle between the true conju-gate and the symphysis has been estimated at 105 degrees. After the physi-cian has made it a rule to combine internal pelvimetry with vaginal examina-tion, he will soon learn to recognize and appreciate departures from the normaltype. An important point, commonly misunderstood, is that the obstetric con- THE E
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
