Case Histories in Diseases of Women Including Abnormalities of Pregnancy Labor

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Case Histories in Diseases of Women Including Abnormalities of Pregnancy Labor
Charles M Charles Montraville Green
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MATURITY 241 CASE LXXXIX A single woman of twenty-one, a waitress by occupation, and a primigravida, applied for care at the Boston Lying-in Hospital at the beginning of the ninth month. She had a justo-minor pelvis, with an estimated obstetrical conjugate of 8 cm. The baby seemed of average size, presented O. L. A. , and the head was not engaged up to the advent of labor! It was regarded as a border-line case, one which might or might not terminate, or safely be terminated, by the pelvic route
...; so it was decided to give the woman the test of labor, and govern the treatment by this experience.
Conduct of the Case. When the young woman entered the hospital at full term, she had been having pains for forty-eight hours. To be sure the pains had not been hard or effective; for but little progress in dilatation had been t made, and the head had not descended. There is always a fair presumption of relative disproportion when the primi- parous head has not at least engaged in the last week or ten days of pregnancy; and in the present case, it seemed im- probable to the writer that the head would mould and descend, if further time were given: so section was decided on, and performed as soon as the patient could be prepared.


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