A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
The =diagnosis= of anteflexion is easily made. The character, position,
and time of onset of the pain indicate some obstruction to the escape
of menstrual blood. Vaginal examination reveals the sharp angle of
flexion at the junction of the body and neck of the uterus.
=Treatment.=--If in a case of anteflexion pregnancy does occur and runs
a normal course the disease will be cured. After labor the uterus does
not return to the infantile shape and size. The stimulus of pregnancy
brings about full permanent development of that organ. Miscarriage,
however, is very apt to occur during the early months of pregnancy,
especially in cases of long standing.
Various methods of treatment have been introduced for the cure of
anteflexion. The object of all these methods is the straightening and
enlargement of the cervical canal. Slow dilatation by graduated bougies
has been successfully employed. Gradual straightening of the canal by
the introduction of the uterine sound with increasing angle of flexion
will also cure some cases, if seen early.
The use of the stem pessary (Fig. 83), which is worn continuously in
the cervical canal, is dangerous and should not be practised.
[Illustration: FIG. 83.--Stem pessary.]
The best method of treatment consists in rapid forcible dilatation
with the uterine dilator. Various instruments have been made for this
purpose. The principle of all is the same. Two blades are introduced,
in contact, in the cervical canal, and are then separated. Two of these
instruments should be on hand--a small and a large dilator. The Goodell
dilator (Figs. 84, 85) is so made that the blades open parallel with
one another, so that the whole of the cervical canal is uniformly
stretched.
[Illustration: FIG. 84.--Goodell’s small uterine dilator.]
[Illustration: FIG. 85.--Goodell’s large uterine dilator.]
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