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In remote, isolated areas, women presenting with a large baby and a small pelvis must travel great distances for medical help; a symphysiotomy has been suggested.
While a heroic concept, symphysiotomy had too many complications for most obstetricians but Jeffray's ideas became accepted, especially after the development of anaesthetics.
Intentional clavicular fracture is a final attempt at nonoperative vaginal delivery prior to Zavanelli's maneuver or symphysiotomy, both of which are considered extraordinary treatment measures.
In former times obstructed childbirth was sometimes treated by cutting the pubic symphysis (symphysiotomy), letting the pelvis halves hinge outwards at the sacroiliac joints.
In October 2003, he promised to examine cases of symphysiotomy in Irish hospitals which occurred during the 1940s and 1950s and offered free health care to those affected.
Later Chitti applies his text book knowledge of symphysiotomy to successfully handle the complicated childbirth of Latha (Devadarshini), Sana's friend.
The hospital was the last in Ireland in which symphysiotomy - the practise in which the pelvis was forcibly widened during childbirth - was carried out.
At that time, Sinn Féin leader Gerry Adams spoke at length to the press, linking the cause of the symphysiotomy survivors with other civil rights causes:
The prototype of the chain saw familiar today in the timber industry was pioneered in the late 18th Century by two Scottish doctors, John Aitken and James Jeffray, for symphysiotomy and excision of diseased bone respectively.