Difficult labour : a guide to its management for students and practitioners / by G. Ernest Herman.

  • Herman, G. Ernest (George Ernest), 1849-1914.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Difficult labour : a guide to its management for students and practitioners / by G. Ernest Herman. Source: Wellcome Collection.

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

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    examination, nothing more; and it does not always give even this help. Value of the obstetric history.—More direct hints may be gained from the obstetric history of the patient, if she have had children before. But this only gives materials for a very rough guess ; for the ease or difficulty of labour depends upon a great many things besides the size and sliape of the pelvis. For instance, the size of the child ; the degree of ossification of its head; the amount of liquor amnii, and the time at which the membranes rupture ; the strength of the pains j the position of the child. In the same patient, from different combinations of these different factors, one labour may be very easy and another very difficult. The configuration of the body.—Except in the case of dwarfs or deformed persons, no conclusion as to the shape of the pelvis can be got from the general configuration of the body, whether the patient be tall or short, robust or feeble. Deformities of the spine and of the lower limbs make us suspect the presence of the pelvic changes which usually go with them ; although even here the amount of pelvic deformity depends upon the age at which the disease began. The only certain information about the size and shape of the pelvis is that gained by pelvic examina- tion and measurement. Pelvimetry.—There are two kinds or degrees of pelvimetry, which I will call complete and practical. Complete jjelvimetry means the measurement of tlie pelvis in all its dimensions as precisely as is possible during the patient's life. This takes a long time. It needs much exposure of the patient, and much manipulation which is very disagreeable to her. It is very difficult to take all the measurements accurately. For these reasons such measurement is not submitted to in English private practice, and very seldom attempted in hospital practice. Still, if such measurement enabled us to manage labour very much better, it would be our duty to advise our patients to