This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1886 Excerpt: ...In these cases the peritoneum is not involved; and the danger is not great. But where the lower segment of the uterus is nipped in the ring of the pelvic brim, the laceration commonly involves all the tissues, at least in some part of the circumference. We then have a direct opening into the peritoneum through which ...
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This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1886 Excerpt: ...In these cases the peritoneum is not involved; and the danger is not great. But where the lower segment of the uterus is nipped in the ring of the pelvic brim, the laceration commonly involves all the tissues, at least in some part of the circumference. We then have a direct opening into the peritoneum through which the child may pass out of the uterus. Frg. 108. RUPTURE, P UTEEUS. Posterior aspect of same uterus as that represented in the preceding figure. The posterior wall of the cervix is bored through by long compression against the jutting promontory of the sacrum. In some cases of great pelvic contraction, where the head has been long compressed upon the brim, the soft tissues are worn down by rubbing and necrosis, and give way transversely at the two points of greatest pressure, viz., at the anterior wall and bladder opposite the symphysis pubis, and at the posterior wall opposite the jutting promontory of the sacrum. In these cases the lesion is always transverse. This is well illustrated in Figs. 107, 108. The subject was a very deformed dwarf, to deliver whom I was called to one of the workhouses. She had been long in labour, and great efforts had been made to deliver after craniotomy. In another class of cases, strictly analogous to the preceding, the head of the foetus has traversed the os uteri and entered the pelvis, when, owing to impaction, a zone of the vagina is nipped. The uterus still striving to drive the child on, pulls upon this fixed vaginal ring, and a transverse or circular laceration occurs. Of this there are many examples. Duparcque thus describes the process: "The child's head arrested on, or more or less engaged in the pelvic brim, the womb continuing to contract pulls itself, so to speak, away from the child. The borders ...
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