Notice d'une infirmière de l'obstétrique, pour l'utilisation dans les écoles de formation . ces surfaces articulaires sont bordées de fibro-cartilage,qui s'épaissit et s'adoucit pendant la grossesse, et «certaine certaine, bien que très limitée, dans les joints de mouvement isessential à un travail normal. Même un de l'ankylose de l'articulation sacro-coccygien, prévenir la bascule en arrière du thecoccyx au moment de la livraison, peuvent nécessiter l'utilisation de pour-ceps, et, dans l'exploitation d'symphyseotomy consistsin, coupant à travers la symphyse pubienne et ainsi de séparer les os thepubic, aucune augmentation de la capacité de la pelvi

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A nurse's handbook of obstetrics, for use in training-schools . these articular surfaces are lined with fibro-cartilage, which becomes thickened and softened during pregnancy, and acertain definite, though very limited, motion in the joints isessential to a normal labor. Even an ankylosis of the sacro-coccygeal articulation, preventing the tilting backward of thecoccyx at the time of delivery, may necessitate the use of for-ceps, and, in the operation of symphyseotomy, which consistsin cutting through the symphysis pubis and so separating thepubic bones, no increase in the capacity of the pelvis could besecured were it not for a very distinct hinge-like motion at thesacro-iliac synchondroses. The pelvis is lined with muscular tissue, which provides asmooth slippery surface over which the foetus has to pass duringlabor, and its bones are bound together by ligaments, whichbecome softened and slightly lengthened as pregnancy advances. Comparing the female with the male pelvis (Fig. 3), wefind that the former is especially adapted to the uses for which. Fig. 3.—Male and female pelvis. A, male pelvis—narrow, heavy, compact; B, femalepelvis—broad, light, capacious. it is designed. It is shallow, but very capacious, lighter in struc-ture and smoother than the male pelvis, which is deep, conical, rougher for muscular attachment, and more compact. The entire problem in obstetrics consists in the safe passageof the fully developed foetus through the pelvis of the mother.Slight pelvic contractions, resulting in tedious or instrumental 26 A NURSES HANDBOOK OF OBSTETRICS. deliveries, are comparatively common, while any such marked de-formity as depicted in Fig. 4 would render labor by the natural

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