Deventer’s pelvis, «gate of life» and the aggressive management of childbirth at the present time. Сlinical observation
A.A. KHASANOV1, 3, F.F. MINULLINA2, 3
1Kazan State Medical University, Kazan
2Kazan Volga Federal University, Kazan
3Republic Clinical Hospital, Kazan
Contact details:
Khasanov A.A. — MD, Professor of the Department of Obstetrics and Gynecology named after Prof. V.S. Gruzdev, Chief Specialist, Chief Researcher
Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-917-239-15-00, e-mail: albirkhasanov@mail.ru
In modern obstetrics, aggressive technologies are often used in the management of childbirth, the harm of which was mentioned by Hendrik van Deventer. The founder of classical obstetrics, born in Holland in 1651 and working during the epoch of obstetrics renaissance, Deventer wrote eight books popular till today. Deventer was an active opponent of aggressive obstetrics — he did not use obstetric forceps, nor the vacuum extraction of the fetus that was emerging at that time. He was the first to give a detailed description of the pelvis and to suggest that the shape and size of the pelvic bone could cause difficulties in childbirth. His instructions — to change the position of a woman in labor with pathological insertions of the fetal head are widely used by modern obstetricians. The term «Deventer’s pelvis» went down in the history of obstetrics – a simple flat pelvis, in which all direct dimensions are reduced (the planes of the entrance, cavity and exit of the pelvis). One of the varieties of Deventer’s pelvis is a reduction of only the direct size of the wide part of the pelvic cavity (with all other normal pelvic sizes), which occurs in 15–18% of all pregnant women. The presented clinical observation shows how the use of the Kristeller’s technique with a delayed fetal head can lead to severe traumatic complications in both the mother and the fetus. The authors recommend measuring the pubic-sacral size, which shows the size of the sacral cavity, to all pregnant women.
Key words: Kristeller’s technique, Deventer’s pelvis, maternal and fetal injuries.
REFERENCES
- Obstetrics in Early Modern Europe, Ms Mallory McFall (University of Kansas). Edward Worth Library, 2023.
- Hendrik van Deventer. The Art of Midwifery Improv’d. London, 1716.
- The van Deventer Lecture Hendrik van Deventer H.L. Houtzager Department of Obstetrics and Gynaecology, St Hippolytus Hospital, Reinier de Graejiveg 1 I, 2625 AD Delft.The Netherlands,1986.
- Provision of medical care for anatomically and clinically narrow pelvis: clinical recommendations. ROAG, 2017 (in Russ.).
- Liby P., Lomachinsky V., Felici G., Vaculik M., Krasnicanova H., Tichy M. Sagittal craniosynostosis associated with midline cephalhematoma or vice versa, case report and a review of the literature. Child’s Nervous System, 2019, vol. 35, pp. 729–732.
- Medical assistance to the mother in case of established or suspected discrepancy between the size of the pelvis and the fetus. Facial, frontal or chin presentation of the fetus, requiring the provision of medical care to the mother: clinical recommendations. ROAG, 2021 (in Russ.).
- Septicheskie oslozhneniya v akusherstve: klinicheskie rekomendatsii (protokol lecheniya) [Septic complications in obstetrics: clinical guidelines (treatment protocol)], 2017.
- Akusherstvo: natsional’noe rukovodstvo, pod red. G.M. Savel’evoy, G.T. Sukhikh, V.N. Serova, V.E. Radzinskogo. 2-e izd., pererab. i dop. [Obstetrics: national leadership, ed. G.M. Savelieva, G.T. Sukhikh, V.N. Serova, V.E. Radzinsky. 2nd ed., revised. and additional]. Moscow: GEOTAR-Media, 2022. 1080 p.