The anatomy of labour as studied in frozen sections, and its bearing on clinical work / by A.H.F. Barbour.

  • Alexander Hugh Freeland Barbour
Date:
1899
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Licence: Public Domain Mark

Credit: The anatomy of labour as studied in frozen sections, and its bearing on clinical work / by A.H.F. Barbour. Source: Wellcome Collection.

    281/424 (page 9)
    Child (female)* lies R.O.A. ; measures 20*2 inches (505 cm.), and weighs 7 045 lbs. (3195 grammes) ; nails, well developed and projecting; labia closing vulva. Cord passes between head and right arm to placenta lying on right side of uterus and low down. Uterus folded over symphysis, its walls relaxed, and showing numerous large empty veins, which in cervix and vagina appear gaping. Vaginal portion lies in left half, so that cervical canal cut into only below, the os internum lying | cm. below the surface. From length of cervix, supposed to be multipara, although no striae. Vaginal portion and contracted bladder lie low in pelvis so that OS externum is at level of lower margin of symphysis, not of upper margin (Morrow) or still higher (Schultze) ; and urethra has a kink on it. Fundus reaches lower margin of first lumbar vertebra, agreeing with Morrow's description ; while Schultze mentions the second vertebra as its height at end of pregnancy. Uterus and abdominal cavity less deep (antero-posteriorly) than usually described, perhaps due to horizontal position of body ; in oadavera, abdominal cavity always shallower from higher position of diaphragm. From S])inal column to posterior abdominal wall is about one-third of whole antero-posterior diameter, while in case described at second month of gestation it was more than one-half. In estimating thickness of uterine walls, must remember that the veins were not injected. Diaphragm reaches seventh dorsal vertebra, instead of ninth or tenth as in men and non-pregnant women. Intestines pushed up- wards, and lie chiefly in upper left portion of abdomen. Rectum passes into iliac flexure Avhile still in pelvis ; between it and uterus lies a coil of the ileum. Peritoneum passes only to short distance on posterior vaginal wall, and covers one-half of contracted bladder anteriorly ; below it, is loose cellular tissue extending to internal orifice of urethra in front and end of rectum behind. Thorax appears short, from high position of diaphragm, and deep ; but cannot infer increase of its base during pregnancy, because we do not know its measurements for this case in the unim- pregnated condition. Anatomical basis not yet got for theory that the absence of change in resjnratory capacity during pregnancy is due to increased breadth compensating for diminished height—vide Gerhard and Dohrn. *In the sections made by anatomists, other i)oints are referred to which have no bearing on labour; and we take no account of these in the following resumes.