. The science and art of midwifery. t of Bandl f to have shown that nearly all rupt-ures begin in the lower segment, and are preceded by an abnormalthinning and distention of that portion of the uterus situated betweenthe ring which bears his name and the os externum. In normal laborit will be remembered that during a pain the fundus and body thicken,while the lower segment is stretched by the ovum. So long as no ob-stacle exists which hindersthe progression of the ovumor the foetus, this processends in the conversion of theuterus and vagina into onecontinuous canal. In suchcases the contracti
. The science and art of midwifery. t of Bandl f to have shown that nearly all rupt-ures begin in the lower segment, and are preceded by an abnormalthinning and distention of that portion of the uterus situated betweenthe ring which bears his name and the os externum. In normal laborit will be remembered that during a pain the fundus and body thicken,while the lower segment is stretched by the ovum. So long as no ob-stacle exists which hindersthe progression of the ovumor the foetus, this processends in the conversion of theuterus and vagina into onecontinuous canal. In suchcases the contraction ring isfound in the neighborhood ofthe pelvic brim. If, however, the descentof the foetus is prevented byany cause, the resistance ofthe ligaments which hold theuterus in position is overcomeby the retraction of the fun-dus and body, and as a conse-quence the contraction ringis withdrawn upward, thelower segment is thinned,while in extreme cases thethickened fundus simply cov-ers the pelvic extremity ofthe child like an inverted. Fig. 243.—Diagram showing dangerous thinning ofthe lower segment, owing to the non-descentof the head in contracted pelvis. (Bandl.) * Harris, If a Woman has ruptured her Uterus, what shall be done in order to saveher Life ? Am. Jour, of Obstet., October, 1880. t Bandl, Ueber Ruptur der Gcbarmutter, Wien, 1875. RUPTURES OF THE GENITAL CANAL. 605 bowl. Under these circumstances it is possible at times to detect bypalpation the contraction ring a hands-breadth above the pubes, oreven in the neighborhood of the umbilicus. The stretching of thetissues is most pronounced in the upper portion of the lower segment,diminishing below until the vaginal portion is reached, which, ofcourse, is not subjected to tension. Now, when, as the result of the birth of any considerable portionof the child into the obstetrical cervix—as the stretched lower uterinesegment has been termed by Spiegelberg—the tissues of the latterare stretched so as to form little more
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