Gynæcology for nurses and gynæcological nursing : including the subjects enumerated, under "gynæcology and obstetrics", in the "syllabus of lectures and demonstrations for education and training in general nursing" issued by the General Nursing Council / by Comyns Berkeley.

  • Berkeley, Comyns, Sir, 1865-1946
Date:
1943
Catalogue details

Licence: In copyright

Credit: Gynæcology for nurses and gynæcological nursing : including the subjects enumerated, under "gynæcology and obstetrics", in the "syllabus of lectures and demonstrations for education and training in general nursing" issued by the General Nursing Council / by Comyns Berkeley. Source: Wellcome Collection.

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    The Pelvis as a Whole. The child has to pass through the pelvis before it is born; if, therefore, the pelvis is smaller than normal, it is obvious that the progress of the child, during its birth, may be hindered or even prevented. If the dried pelvis of a female is examined, it will be found tc^ consist of two parts which are divided by a ridge of bone known as the brim of the pelvis. The brim is formed by the upper margins of the pubic bones in front, the junction of the ilium with the ischium at the sides, and the front of the promontory of the sacrum at the back. That portion of the pelvis above the brim is known as the false pelvis, and that part below the brim is called the true pelvis. False Pelvis.—The false pelvis takes no part in the mechanism of labour, and its importance in midwifery is concerned only with certain measurements which can be taken from various points on its surface and which serve to indicate, to some extent, the size and shape of the true pelvis. True Pelvis.—From the point of view of the mechanism of labour the true pelvis is all-important. Clothed with its muscles and fascia, it is of such a size that the head of the child when in its correct position, namely that of flexion, can just pass through the true pelvis by rotating in a certain direc¬ tion during its transit. There are certain measurements of the true pelvis which are concerned with the progress of the child through the pelvis. The most important of these which can be taken by a nurse is that extending from the under surface of the symphysis pubis to the promontory of the sacrum. This diameter is known as the diagonal conjugate and is, normally, 4! inches long. By subtracting f of an inch from the diagonal conjugate the true conjugate diameter, measured from the tip of the sacral promontory to the back and just below the top of the symphysis pubis, can be esti¬ mated ; this, normally, is 4 inches long. As the true con¬ jugate is the smallest diameter of the pelvis through which the head of the child will have to pass, its importance can easily be realized. If, therefore, the diagonal conjugate is less than 4f inches long the progress of the child will be impeded, or arrested, according to the amount of diminution which is present.