A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . all for careful pelvicmensuration by means of the entire hand. The disease is very;rare in the United States. In Italy and in certain portions oflower Germany it is frequently met with. The etiological causesare the same as those of rickets; but, except in advanced cases,the external configuration of the woman will not suggest thepelvic deformity. OBSTETRIC DYSTOCIA AND ITS DETERMINATION. 29 The characteristics of the osteomalacic pelvis are : Thebones, in general, are softened ; th
A text-book of practical obstetrics, comprising pregnancy, labor, and the puerpal state, and obstetric surgery . all for careful pelvicmensuration by means of the entire hand. The disease is very;rare in the United States. In Italy and in certain portions oflower Germany it is frequently met with. The etiological causesare the same as those of rickets; but, except in advanced cases,the external configuration of the woman will not suggest thepelvic deformity. OBSTETRIC DYSTOCIA AND ITS DETERMINATION. 29 The characteristics of the osteomalacic pelvis are : Thebones, in general, are softened ; the sacrum is small, the promon-tory sinking into the pelvis and approximating the symphysis.! The lumbar vertebrae, in consequence, approach the pelvicbrim. The rami of the pubes bend inward, the pubic anglej being sharply acute and shaped like a beak. The external| measurement between the iliac spines is less than normal, andj that between the crests exceeds that between the spines. As arule, the outlet of the pelvis is narrower than the inlet. Whilstthe conjugate diameter may be only slightly narrowed, the. Fig. 17.—The Osteomalacic Pelvis. transverse is considerably so at the brim and more so in theicavity and at the outlet. In the slighter degrees of deformity due to osteomalacia,jinternal pelvimetry by the entire hand is absolutely essential|not alone for accurate diagnosis, but also for determining thelextent to which the softened pelvic bones can be made to yield!to pressure. It is very essential to determine this latter point,jfor on this depends the determination of delivery per viasaturales with safety to the woman. In many of the reportedlinstances of osteomalacia the indications for Csesarean section J- 30 OBSTETRIC SURGERY. have been absolute. Of 72 cases collected by Litzmann, 38could not be delivered naturally. It is also to be rememberedthat the disease is aggravated in successive pregnancies. If recognized in time, the osteomalacic pelvis calls for theinductio
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Keywords: ., bookcentury1800, bookdecade1890, bookpubli, booksubjectobstetrics
