. An American text-book of obstetrics. For practitioners and students. ng frozen sections mainly,19 observed that the vaginal slit dividesthe structure into an anterior part, which he named the^wftic segment, triangu-lar in shape, composed of retropubic fat, bladder, urethra, and anterior vaginalwall, attached (loosely) to the pubes ; and a much larger and stronger posteriorpart, the sacral segment, between the rear vaginal wall and the posterior bonywall, including the anus and part of the rectum. Symington 20 considers thatthe rectum and bladder and the upper vagina, like the uterus, should
. An American text-book of obstetrics. For practitioners and students. ng frozen sections mainly,19 observed that the vaginal slit dividesthe structure into an anterior part, which he named the^wftic segment, triangu-lar in shape, composed of retropubic fat, bladder, urethra, and anterior vaginalwall, attached (loosely) to the pubes ; and a much larger and stronger posteriorpart, the sacral segment, between the rear vaginal wall and the posterior bonywall, including the anus and part of the rectum. Symington 20 considers thatthe rectum and bladder and the upper vagina, like the uterus, should not beregarded as parts of the floor, but as organs resting upon it. Webster21 holdsthat the bladder is imbedded in the pelvic floor, and that the vagina and cervixare parts of it, together with the rectum from the coccyx down. In the illustra-tion (Fig. 186), for obvious reasons, the bladder and cervix have been omitted. Late in pregnancy the changes that belong to the pelvic floor are relaxationfrom edema, moderate increase in thickness, and a low droop or bulging. V. - FiOOT Fig. 186.—Pelvic floor seen in axial coronal section (modified from Hart). downward. All these changes favor the stretching that is to come. The main-tenance of its former axis by the vagina, its distance from the symphysis, theshape of the pelvic floor at this time, and the low position before it is openedup into an oblique hernial canal are shown in Figures 182, 184, and labor, in the dilatation stage the parts anterior to the vagina are THE PHYSIOLOGY OF LABOR. 339 restrained from being driven down by the upward traction of the longitudinalfibres of the uterus on the anterior lip of the cervix, to which the bladder isattached. As the os is drawn up the bladder and urethra are somewhat elevated,the former coming to lie at the back and partly above the pubes, flatly com-pressed against the bone, together with the urethra, by the descending utero-vesical pouch of peritoneum is strip
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
