. An American text-book of obstetrics. For practitioners and students. y possible insuch cases to push up the anterior lipover the head and above the sym-physis in the intervals between thepains. If there is hypertrophy ofthe anterior lip in consequence of an old laceration and eversion, or, all themore, should there be hypertrophy of the whole infravaginal portion of thecervix, the obstruction may become quite serious, and it may be impossible topush the cervix above the head. In such cases forcible traction on the forcepsor radiating incisions in the cervix may be necessary. Longitudinal sep
. An American text-book of obstetrics. For practitioners and students. y possible insuch cases to push up the anterior lipover the head and above the sym-physis in the intervals between thepains. If there is hypertrophy ofthe anterior lip in consequence of an old laceration and eversion, or, all themore, should there be hypertrophy of the whole infravaginal portion of thecervix, the obstruction may become quite serious, and it may be impossible topush the cervix above the head. In such cases forcible traction on the forcepsor radiating incisions in the cervix may be necessary. Longitudinal septa in the cervical canal are usually seen with duplicity ofthe uterine cavity from failure of the Miillerian ducts to fuse the lack of fusion is confined to the cervical canal alone (uterusbiforis). Rarely transverse septa have been found in the cervical canal,may be necessary to cut these before the child can pass into the vagina. * Cases are reported by Miiller, Breisky, Budin, Henry, Bidder, and Blanc (Pozzis G;/mcoology, vol. ii. p. 456).. Fig. 344.—Double vagina. It DYSTOCIA. 549 Closure and Contraction of the Vagina or Vulva.—There may beobstruction of the lower birth-canal by longitudinal and transverse septa, bycicatrices, by heinatomata, by partial atresia, especially at the upper third ofthe vagina, by unruptured hymen, by anus vaginalis, by vaginal tumors andcysts, by cystic and solid tumors of the vulva, by enlarged carunculae myrti-formes, by varices, by vaginismus, by congenital narrowness of the vagina andvulva, and by rigidity of the tissues, especially in elderly primiparse. Longitudinal and Transverse Septa.—These are not ordinarily very densein structure, and they give way commonly before the advance of the presentingpart. If they do not yield, it is easy to cut them in one or more places, thehemorrhage being controlled, if necessary, by sutures afterward, or in the caseof transverse septa by a double ligature applied first, the
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
