In the third month of pregnancy the uterus rises above the brim of the
pelvis. A slight protrusion of the abdomen may be sometimes observed above
the pubes; the os uteri is not reached so easily as in the preceding
month. The alteration which takes place in the situation of the uterus
during the third month appears to result from gradual shortening of the
broad ligament as it increases in size. As the uterus rises it pushes up
that portion of the small intestines which rests upon it; these however
being confined by the mesentery to the spine, and therefore prevented
ascending before the uterus, at length slip down behind it, and the fundus
being freed from the superincumbent pressure rises in a direction upwards
and forwards into the cavity of the abdomen. The direction of the uterus
becomes much altered; the os uteri is no longer in the middle of the
pelvic cavity, but inclines towards the upper part of the hollow of the
sacrum, whereas the fundus approaches more and more to the anterior
parietes of the abdomen.
In the fourth month, the fundus uteri has risen about two or three
fingers' breadth above the symphysis pubis; this is not very easily
ascertained even in a thin person, still less where the patient is stout
and the parietes of the abdomen therefore thick. The directions which the
celebrated Roederer has given for making an examination of the abdomen
during the early months of pregnancy, are well worthy of notice. Having
evacuated the bladder and rectum, the patient should be placed in a
half-sitting posture with the knees drawn up, so as to relax the abdominal
parietes as much as possible: she must then breathe slowly and deeply; and
if the hand be suddenly pressed against the abdomen a little above the
symphysis pubis, at the moment of her making a full expiration, we shall
in all probability feel the hard globe of the uterus.
In the fifth month, the fundus will be felt half way, or a little more,
between the symphysis pubis and umbilicus. The increased size of the
abdomen cannot be concealed by the dress; the portio vaginalis has become
distinctly shorter, and the os uteri is situated higher in the pelvis and
more posteriorly.
In the sixth month, the fundus has risen as high as the umbilicus; the
irregular folds of the skin which form the fovia umbilici or navel
depression begin to disappear; the first perceptible movements of the
child may occasionally be felt; the portio vaginalis has lost half its
length, being scarcely half an inch in length.
[Illustration: Cervix uteri about the sixth or seventh month.]
Public-domain text, read in full here on John Shaqi.
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