The Disposition of the Pubic Segment in Pregnancy and in Labour

As to the change undergone by the pubic segment during labour, Dr Berry Hart, on the one hand, says in one1 of his latest papers that " the pubic segment is drawn up in part into the abdomen during labour," and that though this occurs most markedly in the second stage it takes place also during the first stage; and he attributes this drawing-up to the upward tension of uterine retraction. On the other hand, Dr Symington2 rather thinks that " the pubic segment is pushed downwards and forwards under the pubic arch," and that " the bladder is the only part of Hart's pubic segment that is not depressed." During the last year I have been able, in conjunction with Dr Barbour, to study four cadavera in the following conditions:? 1. Pregnancy at the beginning of the eighth month; 2. Labour at the commencement of the first stage; 3. Labour late in the second stage; 4. Labour at the end of the third stage. These were examined by means of frozen sections and casts.8 In regard to the disposition of the pubic segment, I have made a special study of these as well as of all the other cases previously published. I have arranged in tabular form the facts acquired by comparative measurements in regard to the follow-