Deventer’s pelvis, «gate of life» and the aggressive management of childbirth at the present time. Сlinical observation

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.