Operative midwifery : a guide to the difficulties and complications of midwifery practice . ry. Transversely Contracted or Roberts Pelvis.—This has some-times been referred to as a double Naegele pelvis, for both ahe of thesacrum are more or less ill-developed. The deformity may besymmetrical or more accentuated on one side (Fig. 86). It is therarest of all the pelvic deformities. As the cavity throughout is sovery much narrowed transversely, it is impossible to deliver a living DEFORMITIES OF THE BONY PELVIS 159 child per vias naturales; consequently, Cesarean section is the onlytreatment if
Operative midwifery : a guide to the difficulties and complications of midwifery practice . ry. Transversely Contracted or Roberts Pelvis.—This has some-times been referred to as a double Naegele pelvis, for both ahe of thesacrum are more or less ill-developed. The deformity may besymmetrical or more accentuated on one side (Fig. 86). It is therarest of all the pelvic deformities. As the cavity throughout is sovery much narrowed transversely, it is impossible to deliver a living DEFORMITIES OF THE BONY PELVIS 159 child per vias naturales; consequently, Cesarean section is the onlytreatment if the child is alive. Split Pelvis.—This variety is extremely rare in ohstetric practice,being commonly associated with ectopia of the bladder and othermalformations of the generative and urinary organs. The pubicbones may be separated as much as 4 inches ; they are united byiibrous tissue. The transverse diameters are increased. A mostinteresting case of labour in such a pelvis has been described byAdam1 of Hamilton (Figs. 87 and 88). There are only some dozensimilar cases on Fig. 87.—Split Pelvis. {From a drawing by Dr. J. Lindsay of the case recorded by Dr. Adam of Hamilton., and kindly lent the Author.) Assimilation Pelvis. — There are here figured two forms ofassimilation pelvis. In one the sacrum consists of four (Fig. 89) andin the other of six fused vertebrae (Fig. 90). Such departures fromthe normal are rarely recognized during life, and are of no obstetricinterest. II. Deformities the Result of Disease of the Pelvic Bones and Joints. In this country, and in temperate climates generally, rickets isthe chief factor in the causation of pelvic deformities. But although1 Journ. Obstet. and Gyn. Brit. Empire, vol. ii., October, 1902, p. 3771. 160 OPERATIVE MIDWI! i:i;V rickets is so generally distributed over the continents of both Europeand America, it is more prevalent in certain countries than in others,and, speaking generally, it is a disease of large cit
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