The practice of obstetrics, designed for the use of students and practitioners of medicine (1910) (14796307563)

Identifier: practiceofobstet00edga (find matches)
Title: The practice of obstetrics, designed for the use of students and practitioners of medicine
Year: 1910 (1910s)
Authors: Edgar, J. Clifton (James Clifton), 1859-1939
Subjects: Obstetrics
Publisher: 3rd ed., rev
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons



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erous infiltration, with which passive dilatation ofthe blood-vessels is associated. At the end of the fourth month the lips of theOS are entirely changed in consistence, being soft and velvety on palpation.By the sixth month one-half of the cervix has participated in this change, andby the eighth the entire cervix is involved. 2. Volume.—The cervix takes part in the hypertrophy of the entire uterus,its volume changing somewhat as pregnancy advances. This increase, how-ever, does not compare in extent with that of the body of the uterus. 3 Situation and Direction.—In the first three months the cervix is 90 PHYSIOLOGICAL PREGNANCY. lower in the pelvis and a trifle to the left. This position results from the in-creased weight and the pressure upon the fundus toward the right by the dis-tended rectum. After the third month the cervix rises higher in the pelvis MESO-SIGMOIDUTERUS \ RECTO-VAGINAL POUCH RECTUM \ LEFT COMMON ILIAC V RIGHT COMMON ILIAC A ROUND LIGAMENT OF UTERUS UMBILICUS
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DEEP EPIGASTRIC AFALLOPIAN TUBEOVARY UTERO VESICAL POUCHBLADDER RAPHE OF LEVATOR ANi M EXTERNAL SPHINCTER ANI M DORSAL VEIN OF CLITORIS VESICAL PLEXUS OF VEINS\ URETHRA INTERNAL SPHINCTER ANI M PERINEAL BODY Fig. 117-—Sagittal Section of Normal Adult Pelvis.—(Deaver.) till the last two or three weeks of gestation, when it sinks again. Sometimestoward the end of pregnancy, if the head is the presenting part, it pushes forwardthe lower anterior wall of the uterus, causing the cervix to point backward. CHANGES IN THE UTERUS. 91 or even a little upward.* The cervix changes in direction according to themovements of the uterine body. 4. Cervical Canal.—Coincident with the cervical softening, the cavitybecomes broader, and the external os patulous. The time of this change variesaccording as the patient is a primigravida or a multigravida. Sometimes, inthe former case, the external os remains closed till the end of pregnancy; buteven under these circumstances it generally becomes patulo