Case of delivery, without operative aid, through a pelvis extremely deformed by malacosteon / by J.Y. Simpson.

  • Simpson, James Young, 1811-1870.
Date:
1847
Catalogue details

Licence: Public Domain Mark

Credit: Case of delivery, without operative aid, through a pelvis extremely deformed by malacosteon / by J.Y. Simpson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    10/24 (page 8)
    of embryulsio, would have been followed by British practitioners. This remark specially applies to the thirty cases included in the two last lines of the table; and it applies to them the more strongly when we further recollect that the sizes of these pelves in English measurements would have been somewhat more than they appear under French measurements, the French inch being about j\ part longer than the English inch. In choosing in any case of contracted pelvis, between the alter- natives of craniotomy and the Caasarean section, Continental prac- titioners generally look upon the life of the child, as well as the ]5robable degree of difficulty and danger likely to ensue to the mother from a painful and protracted delivery by embryulsio, as important points and elements in deciding between these two methods of delivery. In this country, little, or indeed no atten- tion has hitherto been given to these considerations in forming a practical conclusion on the question. In fact, British accoucheurs have never deemed themselves entitled to have recourse to the Caesarean section, unless the pelvic apertures were so much re- duced as to prohibit the practicability of the extraction of the child through them by embryulsio. With them the propriety of delivery by the Caesarean section begins exactly with that degree of pelvic deformity at which the possibility of delivery by em- bryulsio terminates. Hence In order to fix and determine the highest limit of pelvic contraction which necessitates the performance of the Cassarean section, we have merely. In the first instance, to fix and determine the lowest limit of pelvic contraction at which delivery by em- bryulsio is capable of being effected. The following table presents, in a condensed form, the opinions of various British and American obstetricians upon this question, namely, the actual degree of pelvic contraction above which it is considered still possible to deliver by embryulsio, and below which It Is deemed proper, and absolutely necessary to extract the Infant by the Caasarean section. Smallest Pelvic Diaineters admitting of the Passage of a Child bxj Embryulsio. 3^ inches by 2 Inches Dewees,' Bedford,^ &c. 8 by If Burns,3 Hull,^ &c. 3 by 1^ Barlow,^ Hamilton, &c. 1 By a sufficient diameter I mean, where there is at least two inches in the antero-posterior, and at least three and a half in the transverse ; below this, delivery pervias nattirales, I repeat, I believe to be impossible.—Z>e<cecs System of Midwiferi/(18S7), V. 570. 2 « I do not believe it is possible to remove a child by embryotomy, when the antero-posterior diameter of the superior strait measures less than two