File:A textbook of obstetrics (1899) (14755004996).jpg

Identifier: textbt00hirs (find matches)
Title: A textbook of obstetrics
Year: 1899 (1890s)
Authors: Hirst, Barton Cooke, 1861-1935
Subjects: Obstetrics
Publisher: Philadelphia : Saunders
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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s on the rim of the pubic bones, and theposterior parietal bone is the first portion of the childs head toenter the pelvis. The presentation of the posterior fontaneloccurs even in normal pelves as a rare exception, but is seen inabout ten per cent, of contracted pelves (Schauta), and is theresult in them very likely of firm abdominal walls and anincreased inclination of the pelvic inlet to the axis <A the trunk. 428 THE PATHOLOGY OF LABOR. In these cases the anterior parietal bone is pushed under theposterior at the sagittal suture. When the posterior side of thehead by descent finds room in the hollow of the sacrum andmoves backward, the anterior portion of the skull glides overthe symphysis and the sagittal suture moves from its originalposition, just behind the symphysis, toward the median line ofthe pelvic canal. In addition to these anomalies of mechanismBreisky describes what he calls an extramedian engagementof the head in cases of flat pelvis in which there is considerable
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Fig. 285.—Marks made by the promontory on the childs head and face( Fritsch and Kiisther). lordosis of the lumbar vertebrae. The head in extreme flexionis forced down upon half of the pelvic inlet, and enters the pelviccanal on this side alone. Directly the obstructing promontoryand lumbal- vertebra are passed the head descends the pelvic canal with rapidity and ease-. This mechanism was noted nine-teen times in Breiskys clinic among 2002 labors.1 1 l»i« Becken Anomalien, by Friedrich Schauta, in Mailers Handbuch derGeburtshttlfe, Bd. ii; Betschler, Annal. n der klinischen Vnstalten, i. pp. 24, 60;n. p. 31; Engelken, Dis.-Inaug., Mrm.ln-n.1S7S; Zur Kentniss der extra-median Einstellung des Kopfes, Kohn, Prager Zeitschrifl f. Heilkunde, Bd ix ANOMALIES IN THE FORCES OF LABOR. 429 Justominor Pelvis.—In this type of contracted pelvis theform of the female pelvis is preserved, but the size is diminishedThree divisions of this pelvis are commonly made : The juvenile, in which the bon

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