. The science and art of midwifery. casethe pelvis, provided the path-ological processes have onlyadvanced to a limited extent,retains a symmetrical appear-ance, and resembles closely the justo-minor pelvis. The rachitic ori-gin is betrayed by the shape of the ilia and the signs of ricketsin other parts of the body. At the outlet the antero-posterior di-ameter is increased, and the transverse diameter somewhat dimin-ished.* 2. In cases of excessive softening of the bones, either from the se-verity or the long duration of the disease, the acetabula are sometimespushed inward, upward, and backwa
. The science and art of midwifery. casethe pelvis, provided the path-ological processes have onlyadvanced to a limited extent,retains a symmetrical appear-ance, and resembles closely the justo-minor pelvis. The rachitic ori-gin is betrayed by the shape of the ilia and the signs of ricketsin other parts of the body. At the outlet the antero-posterior di-ameter is increased, and the transverse diameter somewhat dimin-ished.* 2. In cases of excessive softening of the bones, either from the se-verity or the long duration of the disease, the acetabula are sometimespushed inward, upward, and backward, and the symphysis pushedforward, so that the rami of the pubes meet at an acute angle, or runnearly parallel to one another. This lateral compression, in conjunc-tion with the rachitic projection of the promontory, gives to the pelvicbrim a triangular or clover-leaf shape, closely resembling the distor-tion produced in osteomalacia. The term pseudo-osteomalacia given * Schroeder, Schwangerschaft, Geburt. und Wochenbett, p. Fig. 221.—Pseudo-osteomalacia. (Naegelc.) CONTRACTED PELVES. 475 by Michaelis * to this form is warranted by the existence of certainfeatures peculiar to rickets, such as the small size of the ilia, the dis-tance between the anterior superior spinous processes, and the natureof the changes in other parts of the bony In curvatures of the spine the shape of the pelvis is affected, whena compensatory scoliosis or kyphosis includes the sacral extremity : 1. In scoliosis (lateral curvature), all the rachitic features are usu-ally strongly pronounced. The promontory is tilted to the side of theincurvation, and is pressed by the weight of the body toward the cor-responding acetabulum. Theilium, owing to the increasedpressure at the acetabulum fromthe femur of the affected side,is pushed upward, backward,and inward. In extreme casesthe approximation of the prom-ontory to the acetabulum maybe such as to prevent the en-trance of the childs head. T
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Keywords: ., bookcentury1800, bookdecade1890, bookidsci, booksubjectobstetrics
