Page:Clinical Lectures on the Diseases of Women.djvu/31

 In fact, the cases have no analogy to one another except in the circumstance that you have the deformity of the pelvis gradually increasing from one pregnancy to another, and requiring, as the deformity advances, different kinds of delivery if the woman is allowed to go on to full time.

The next case is one of a commoner kind — -a case of gene- rally contracted rickety pelvis. This woman, aged twenty- seven, was brought into Martha ward in labour on June 24 last. She has been deformed since childhood, and is of low stature, measuring four feet two inches. She was married on September 24, and has had no catamenial discharge since then. Pains began on the 22nd ; they were never severe. The cord became prolapsed on the morning of the day of admission — it is pulseless. The diameter of Baude- locque was found to measure five inches and a half, the crests measured eight inches and a quarter, while the spines measured more — eight inches and a half. The uterus has a natural feeling, projects extraordinarily, and has a left lateral obliquity. Through the hypogastrium the child's head can be felt, movable. The limit of the uterus and cervix not distinctly felt, from the pains being slight — it is about half an inch below the level of the navel. The ex- ternal parts are swollen and congested. The external os uteri is dilated to the size of a florin. The head presents in the first position. Two fingers can with difficulty be squeezed into the conjugate, which is almost an inch and a half, and there is no considerable increase of any antero- posterior diameter of the brim at any part. Some pelvic brims have dilatations at one or both sides of the promontory ; in this case there was no increase. Caesarian section was performed, and proved fatal from septic peritonitis of slight extent and degree upon the third day. In this case the callipers were used, and they alone indicated very accurately the kind of deformity and the degree. But the fingers gave an ad- ditional measurement by being jammed into the actual and