Aids to obstetrics : double part / by Samuel Nall.

  • Nall, Samuel.
Date:
[1885?]
Catalogue details

Licence: Public Domain Mark

Credit: Aids to obstetrics : double part / by Samuel Nall. Source: Wellcome Collection.

    80/150 (page 76)
    of the outlet. The obstruction is very great, and Caesarian section is often required. 9. The Kyphotic Pelvis has the conjugate of the brim increased owing to the rotation of the base of the sacrum backwards. The transverse diameter of the brim and all the diameters of the out- let are lessened. The pubic arch is narrow. The obstruction increases towards the outlet. 10. Pelvis deformed by Osteo-Malacia.—This disease pro- duces softening of the pelvic bones. Owing to the pressure exerted on the softened bones the following deformities arise : The sacral promontory projects forward ; the sacrum is very curved; the lateral walls of the pelvis are pressed inwards at the acetabula, so as to shorten both oblique diameters; the tuberosi- ties of the ischia and sides of the pelvis are pressed towards one another, and thus the dimensions of the cavity and outlet are greatly lessened. The pubes often project forwards and become beaked. Great deformity is thus produced, and craniotomy or Caesarian section may be necessary; occasionally, however, the bones are plastic and allow the foetus to pass. 11. Deformities depending on Exostoses, Tumours, etc.— Exostoses, malignant growths of the sacrum and other pelvic bones, may encroach on the pelvic cavity, and cause obstruction, and injury to the overlying soft parts during delivery. Caesarian section may be required. Influence of Deformed Pelvis on Pregnancy and Labour. In cases of deformed pelvis, the uterus is often anteverted, and pendulous abdomen is very common; the uterus is also higher and more movable than natural, as it cannot sink into the pelvis. Malpresentations are very common, partly owing to the great mobility of the uterus, and partly because the anteverted con- dition of the uterus and the pelvic contraction tend to carry the head away from the brim. During labour the difficulty of course varies with the degree of contraction; the pains are always strong, but the mobility and anteversion of the uterus prevent them from acting efficiently. If the deformity is slight the pains may effect delivery.