PREGNANCY. 33 



non-gravid state, the fundus inclines somewhat backwards, the os 

 uteri being nearly in the centre of the pelvic cavity ; the gravid uterus, 

 during the later half of pregnancy, has its fundus inclined forwards, 

 and the os uteri directed backwards towards the upper part of the 

 hollow of the sacrum. 



During the first mo7ith^ the changes are not very appreciable, the 

 uterus is larger, softer, and more vascular, the os and cervix are soft, 

 and cushiony, as during the menstrual period, and the transverse 

 fissure is more oval. 



During the second mo7ith, abdomen somewhat flat, cervix in- 

 creased in size, and the os uteri can be felt lower than natural ; its 

 shape also is changed, being round and smooth in primiparse, while 

 in multiparse it is larger and irregular in shape. The canal of the 

 cervix is closed by a gelatinous plug. 



During the third mo?ith^ slight protrusion of the abdomen, os 

 uteri not so easily reached, and somewhat changed in position ; it is 

 no longer in the middle of the pelvic cavity, but inclines towards the 

 hollow of the sacrum, while the fundus approaches more nearly to 

 the anterior parietes of the abdomen. 



During the fourth month, the fundus may be discovered two or 

 three inches above the symphysis pubis in thin persons by pressure, 

 having first relaxed the abdominal parietes, and emptied the bladder 

 and rectum. 



During the fifth month, the cervix is drawn out by the expanding 

 uterus and shortened, and the fundus may be felt halfway i)etween 

 symphysis pubis and umbilicus. 



During the sixth month, the cervix has lost very nearly one-half 

 its length, the fundus is as high as the umbilicus, and the navel de- 

 pression begins to disappear. 



During the seventh month, the cervix is only half its original 

 length ; the fundus rises a little above the umbilicus, which often be- 

 comes pointing. The head may also be felt per vaginam by hallotte- 

 ment, and the movements of the child detected through the abdominal 

 walls. 



During the eighth month, the cervix is not more than a quarter 

 of an inch long, abdomen increased considerably in size, and the os 

 uteri so high as scarcely to be reached. The fundus is about mid- 

 way between umbilicus and scrobiculus cordis. 



During the ninth month, the neck is obliterated, so that upon 

 making an examination, we find the vagina closed superiorly by the 

 rounded lower end of the uterus, and in primiparse the fundus is at 

 the scrobiculus cordis. During the last few weeks of pregnancy the 

 fundus sinks a little, the abdomen falls, the os uteri appears only as 

 a little dimple, and its edges are thin and membranous ; it occupies 

 now the upper part of the hollow of the sacrum. In women who 

 have borne many children the cervix does not entirely disappear. 



