Cesarean section . cian in charge of the second labor has assumed that hissuperior training warranted the assumption that he could succeed wherehis predecessor had failed, and he has thus been led into the error ofnot profiting by his patients previous history and has sacrificed herinterests to his own conceit. It is fair to say tiiat, if a patient with aborder line pelvis has lost one child as a result of a difficult operativedelivery, cesarean section in succeeding pregnancies is advisable, andthat, if she has lost more than one, the indication is absolute. INDICATIONS FOR CESAREAN SECTION 2
Cesarean section . cian in charge of the second labor has assumed that hissuperior training warranted the assumption that he could succeed wherehis predecessor had failed, and he has thus been led into the error ofnot profiting by his patients previous history and has sacrificed herinterests to his own conceit. It is fair to say tiiat, if a patient with aborder line pelvis has lost one child as a result of a difficult operativedelivery, cesarean section in succeeding pregnancies is advisable, andthat, if she has lost more than one, the indication is absolute. INDICATIONS FOR CESAREAN SECTION 25 The examination should also include a careful estimation of thesize of the childs head and comparison of it with the maternal pelvis bythe various methods advised for measuring the fetal head, but theseprocedures, although of distinct value, do not give accurate informationas to the outcome of labor, owing to the fact that other factors enterinto the problem to a greater or less extent. It is undoubtedly the case. Fig. 10.—Measurement of Anteroposterior Diameter at Outlet(Williams Method). that in expert hands such an examination will reduce the margin of errorto a minimum, but the fact remains that the ultimate result in a certainnumber of cases depends on other factors which cannot be determineduntil the patient has been in labor for some time. The other factorswhich must be taken into consideration are: the probable character ofthe labor, , the strength and frequency of the uterine contractions,the time at which the membranes rupture, whether before or after dilata-tion of the cervix has been attained; the rigidity of the soft parts, andthe molding power of the childs head. In addition, the effect of a hard 26 CESAREAN SECTION labor on the individual patient must be taken into consideration in de-termining the best method of delivery, since in women who are belowthe normal standard, either physically or nervously, the exhaustion of aprolonged and severe labor may lea
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