File:Essentials of obstetrics (1897) (14764532482).jpg

Identifier: essentialsofobst00jewe (find matches)
Title: Essentials of obstetrics
Year: 1897 (1890s)
Authors: Jewett, Charles, 1839-1910 Jewett, Harold Flagg, 1869- joint author
Subjects: Obstetrics
Publisher: New York, Philadelphia, Lea Brothers & Co.
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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vantage is still greater inmalpresentations and malpositions, by reason of the greaterinequality of pressure on different parts of the resistinggirdle. The membranes rupture usually by the time they reachthe pelvic floor, often sooner, or only on interference. Softening of the cervix, established before labor, is muchincreased in course of the first stage. During a pain thewalls of the uterus are everywhere compressed by contrac-tion upon its contents, except at the cervix. The blood-vessels of the cervix, unsupported by pressure, becomeengorged, and a serous transudation takes place into itstissues, loosening its structure. PHYSIOLOGY OF LAB OB. 115 detraction ring. In course of the first stage of laborthe upper uterine segment becomes thickened, retraction ofthe muscular structures into that segment taking place witheach pain; the lower segment becomes correspondinglythinned. The line of demarcation between the thickenedupper and the thinned lower segment is the contraction Fig. 35.
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The uterus after complete canalization of the utero-cervical zone. CR. Con-traction ring or retraction ring. oi. Os internum, oe. Os externum. ring, or, as it may more properly be termed, the retractionring. The retraction ring can generally be felt above thebrim by the close of the first stage, and it rises higher inproportion to the number and strength of the pains. 116 ESSENTIALS OF OBSTETRICS. Retraction of the pubic segment. The posterior wall ofthe bladder and the whole pubic segment of the pelvic floorbegin to be drawn upward during the latter part of thestage of dilatation. The elevation is marked during thesecond stage. The bladder is thus lifted partly out of thelesser pelvis away from injurious pressure during the birth.Only a very small portion of the organ rises above the levelof the pubic bones. The length of the urethra remainsunchanged. The duration is from two or three hours to several days-The average length of this stage is in primiparse, elevenhours ; in nmltiparse

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