The practice of obstetrics, designed for the use of students and practitioners of medicine . bent forward, and thepelvic inclination diminished(Fig. 867). The sacrum ishigher, straighter, longer; itslateral concavity is increasedso that its width is lessened(Fig. 870). The conjugate ofthe inlet is increased. The an-terior spines of the iliac bonesare pushed further apart,while the posterior spines aremore closely approximated,this latter effect being the re-sult partly of the pull exertedby the sacro-iliac ligamentsand partly of the narrownessof the sacrum. The widthof the pelvis is decreasedt
The practice of obstetrics, designed for the use of students and practitioners of medicine . bent forward, and thepelvic inclination diminished(Fig. 867). The sacrum ishigher, straighter, longer; itslateral concavity is increasedso that its width is lessened(Fig. 870). The conjugate ofthe inlet is increased. The an-terior spines of the iliac bonesare pushed further apart,while the posterior spines aremore closely approximated,this latter effect being the re-sult partly of the pull exertedby the sacro-iliac ligamentsand partly of the narrownessof the sacrum. The widthof the pelvis is decreasedthrough its whole depth, mostmarkedly so at the outlet onaccount of the approximationof the spines of the coccyx and the end of thesacrum are pushed forward,thus decreasing the pelvicoutlet. The narrower thisoutlet becomes, the wider theinlet, for the outward forceexerted on the iliac crests isincreased, this effect beingheightened by the extrastrain on the ilio-f emoral liga-ments which pull the anteriorinferior spines downward and MATERNAL DYSTOCIA FROM OBSTRUCTED LABOR. 645. Fig. 869.—Escape of theHead under the PubicArch in a KyphoticPelvis.—-{Tarnier.) outward. In order that the body may not fall forward, there occurs a slightflexion of the knees and thighs, while there is scarcely any pelvic inclination (). When the deformity is lumbo-sacral there maybe involvement of the superior part of the sacrum inthe pathological process and its tissues ma^ be de-stroyed (Fig. 863). The promontory of the sacrum ispalpated with difficulty per vaginam. Diagnosis: Thehistory of the case is generally plain, and the deformityvery evident. As in all cases of pelvic deformity, themeasurements are most valuable. They show that theanterior spines and crests of the ilia are more widelyseparated, while the posterior spines as well as theischial tuberosities are approximated. The conjugateof the outlet is to some extent decreased. Complica-tions such as asymmetry, general co
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectobstetrics, bookyear1
