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Fehling's remarkable case probably partly traumatic in its origin.
The woman was sixty-three years old, and had had eleven deliveries and one abortion. For fifteen article rewriting services years she had had a prolapsus which had been left itself. One day, after going the fourth floor with a pail o£ water, protruded very greatly, and she attempted replace forcibly with her hands.
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A fatal rupture the posterior vaginal wall, with prolapsed coils intestine, occurred. The history this case furnishes i need help writing my thesis statement us with a key a similar condition, which Rokitansky once found postmortem. In these cases the traumatic influences were slight, and they may be placed the side the spontaneous cases.
They presuppose an excessive friability the vaginal walls from a pathological process some kind, together with a sudden increase in vaginal tension from ascites, retroversio uteri, or hernia buy term paper post, etc. Now as vaginal raptures which occur subpartu. They occur both with natural and with artificial deliveries. If do not include the very frequent fissures the mucous membrane at the hymenal insertion, which occur in most first deliveries, vaginal ruptures are i need help to write essay rare accidents in childbirth.
cases rupture M'Clintock counts as affecting the vagina especially.
We can easily appreciate the conditions which predispose vaginal rupture in childbirth.
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The excessive tension and stretching the walls the prime factor, especially when there any disproportion between the want to buy a research best admission essay editing service paper advancing part and the vaginal buy a research paper now tube. An unequal amount tension academic writing services jobs therefore exerted sometimes spontaneously abnormal positions the head, but much more frequently from a faulty direction the forceps in extraction.
As a rule the posterior wall, being the one most subject tension, the one that ruptured. The rapidity with help formulating a thesis which the vagina dilated a factor, as also the condition the vaginal tissue as regards extensibility.
Deep fissures at the upper and lower segments the tube generally involve the neighboring organs. Thus ruptures the vaginal vault usually involve that the cervix uteri those near the vaginal entrance are continuous with perineal rents. But we see uncomplicated fissures at both places. Those the vaginal vault then often form transverse tears, and sometimes essay help for college application spread far in a circular form as completely separate the uterus from the vagina. Hugenberger, who has described this variety rupture minutely under the name of kolpoporrhexis, has collected cases, occurring in his own practice. Seventeen them were anterior, posterior more or less complete separation vagina and uterus. Like uterine ruptures, they occurred most frequently in multipara, in whom there was marked disproportion between pelvis and foetus. In either case the essential cause spontaneous rupture the enormous stretching and tension of the cervical and vaginal walls, which occurs when there an impassable obstacle, and the internal behind the head or other prominent part the child.