Abnormalities of bony pelvis

Август 10, 2022

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Abnormalities of bony pelvis

Содержание

2. Derived from latin word means Basin Ring of bone: Two hip bone Sacro-coccygeal part of vertebral
3. The False Pelvis is that portion above the pelvic brim. It does not take part in
5. The True Pelvis is that portion below the pelvic brim. It determines the size and shape
6. PELVIC INLET Pelvic inlet is formed from behind forward by Sacral promontory Anterior margins of ala
8. A-P diameter or anatomical conjugate Extends from middle of sacral promontory To the upper margin of
10. PELVIC CAVITY Extends downwards and backwards from pelvic inlet,intervenes between inlet and outlet. Posterior wall of
11. PELVIC CAVITY Anterior posterior diameter: From middle of the back of symphysis pubis to the pelvic
12. . Pelvic outlet It is diamond shaped and wider in female. Boundaries In front Lower margin
13. Pelvic outlet ( inferior view )
14. PELVIC OUTLET Anterior –posterior diameter: from lower border of symphysis pubis to tip of the coccyx.
16. Types of pelvises Gynaecoid Anthrapoid Android Platypelloid
17. GYNAECOID PELVIS Ideal pelvis favouring a normal delivery; 50.6% of women Brim slightly ovaltransversely but almost
18. Male-type pelvis favouring OP positions and apt to cause deep transverse arrest of head; 22.4% of
19. Ape-like pelvis favouring OP positions often requiring operative vaginal deliveries; 22.7% of women. Brim AP oval
20. PLATYPELLOID PELVIS Leads to cephalo-pelvic disproportion; 4.4% of women. Brim oval transversely Sacrum very slightly curved
21. Asymmetrical pelvises
23. Clinical Assessment Body build
24. Engagement defined as the point when the engaging diameter [BPD(biparietal diameter = ~10 cm] goes past
25. In Gynaecoid & Android pelvis distance between ischial spine to brim is ~5 cm. In Anthropoid
26. vaginal examination
27. Clinical Assessment vaginal examination
28. vaginal examination
29. Presentation of the fetus at the time of delivery
30. CLINICAL ASSESSMENT RADIOLOGICAL EXAMINATION TRUE AP CONJUGATE OBSTETRIC CONJUGATE MID-CAVITY AP CONJUGATE OUTLET AP CONJUGATE ANGLE
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Derived from latin word means Basin
Ring of bone:
Two hip bone
Sacro-coccygeal part

of vertebral column
The pubic part of hip bone connected by pubic Symphysis.
Pelvic bone is made up of various sections:
For obstetrical purposes, the pelvis is divided by the pelvic brim into two parts:
The False Pelvis
The True Pelvis

INTRODUCTION

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The False Pelvis is that portion above the pelvic brim. It

does not take part in the mechanism of delivery and is of no obstetric interest.
Intercristal diameter [IC ~29 cm]: widest point on lateral aspect of iliac crest
Interspinous diameter [IS ~26 cm]: distance between the lateral tips of the anterior superior iliac spines
External conjugate [AP] diameter [EC ~20 cm]: distance between apex of spine of 5th lumbar vertebra and centre of the superior border of symphysis pubis.

FALSE PELVIS

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The True Pelvis is that portion below the pelvic brim. It

determines the size and shape of the birth canal.
Pelvic Brim or Pelvic inlet: formed by the upper margins of pubic bones, the ilio-pectineal lines and the anterior upper margin of the sacrum.
Cavity: formed by the pubic bones, ischium, ilium, and sacrum
Outlet: diamond-shaped made up of the pubic bones, ischium, ischial tuberosities, sacrotuberous ligament, and 5th segment of sacrum

TRUE PELVIS

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PELVIC INLET
Pelvic inlet is formed from behind forward by
Sacral promontory
Anterior margins

of ala of the sacrum
Linea terminalis
Upper end of symphysis pubis.

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A-P diameter or anatomical conjugate Extends from middle of sacral promontory

To the upper margin of symphysis pubis.
Oblique diameter:
Sacroiliac joint of one side to the iliopubic Eminence of other side.
Transverse diameter:
Widest of all the diameters.

PELVIC INLET

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PELVIC CAVITY
Extends downwards and backwards from pelvic inlet,intervenes between inlet and

outlet.
Posterior wall of the cavity longer than anterior wall.
Boundaries Anteriorly
By symphysis pubis and body of the
pubis with its rami
Posteriorly
Concave pelvic surface of sacrum and
coccyx.
On each side
Quadrangular area formed by pelvic surface of ilium and ischium.

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PELVIC CAVITY
Anterior posterior diameter:
From middle of the back of symphysis pubis

to the pelvic surface of third sacral vertebrae.
Oblique diameter:
Lower end of sacroiliac joint to the centre of
obturator membrane.
Transverse diameter:
Across the lateral bony walls of pelvic cavity.

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.
Pelvic outlet
It is diamond shaped and wider in female.
Boundaries In front
Lower

margin of symphysis pubis
connected by arcuate pubic ligament
Behind
Tip of the coccyx
Anterolaterally
Conjoint ischiopubic rami.
Laterally
Ischial tuberosities.
Posterolaterally
The sacrotuberous ligament.

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Pelvic outlet ( inferior view )

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PELVIC OUTLET
Anterior –posterior diameter:
from lower border of symphysis pubis to tip

of the coccyx.
Oblique diameter:
Between the junction of ischio-pubic ramus of one side and middle of the sacrotuberous ligament of the opposite side.
Transverse diameter:
between the medial surfaces of the lower ends of ischial tuberosities.

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Types of pelvises
Gynaecoid
Anthrapoid
Android
Platypelloid

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GYNAECOID PELVIS
Ideal pelvis favouring a normal delivery;
50.6% of women
Brim slightly ovaltransversely

but almost Rounded.
Sacrum curved Ischial spines not prominent
Short-cone pelvis
Obtuse greater sciatic notch
Triangular obturator foramen
Sub-pubic arch rounded [Roman arch] angle at least 900

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Male-type pelvis favouring OP positions and apt to cause deep transverse

arrest of head; 22.4% of women.
Brim heart-shaped Sacrum curved
Ischial spines prominent Long-cone funnel pelvis Acute greater sciatic notch Oval obturator foramen
Sub-pubic arch very narrow [Gothic arch]

ANDROID PELVIS

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Ape-like pelvis favouring OP positions often requiring operative vaginal deliveries; 22.7%

of women.
Brim AP oval
Sacrum very slightly curved Ischial spines prominent
Long-cone funnel pelvis with straight sidewalls
Obtuse greater sciatic notch
Oval obturator foramen
Sub-pubic arch narrow

ANTHRAPOID PELVIS

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PLATYPELLOID PELVIS
Leads to cephalo-pelvic disproportion; 4.4% of women.
Brim oval transversely Sacrum

very slightly curved Ischial spines prominent Short-cone shallow pelvis Acute greater sciatic notch Triangular obturator foramen Wide arch narrow

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Asymmetrical pelvises

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Clinical Assessment Body build

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Engagement defined as the point when the engaging diameter [BPD(biparietal diameter

= ~10 cm] goes past the pelvic brim.
Five fingers = 10 cm.

Fifths palpable above symphysis pubis

CLINICAL ASSESSMENT FOETAL HEAD AS PELVIMETER

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In Gynaecoid & Android pelvis distance between ischial spine to brim

is ~5 cm.
In Anthropoid pelvis distance is ~7 cm
In Platypelloid pelvis distance is ~3
cm
Station of the head in
relation to ischial spines

CLINICAL ASSESSMENT FOETAL HEAD AS PELVIMETER

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vaginal examination

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Clinical Assessment vaginal examination

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vaginal examination

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Presentation of the fetus at the time of delivery

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CLINICAL ASSESSMENT RADIOLOGICAL EXAMINATION
TRUE AP CONJUGATE
OBSTETRIC CONJUGATE
MID-CAVITY AP CONJUGATE
OUTLET AP CONJUGATE
ANGLE

GREATER SCIATIC NOTCH
ANGLE OF INCLINATION OF PELVIC BRIM
ANGLE OF INCLINATION OF SACRUM
ISCHIAL SPINE
ISCHIO-TUBEROUS DISTANCE
FOETAL HEAD
LIE, POSITION, ENGAGEMENT

Abnormalities of bony pelvis

Содержание

Derived from latin word means BasinRing of bone:Two hip boneSacro-coccygeal part

The False Pelvis is that portion above the pelvic brim. It

The True Pelvis is that portion below the pelvic brim. It

PELVIC INLETPelvic inlet is formed from behind forward bySacral promontoryAnterior margins

A-P diameter or anatomical conjugate Extends from middle of sacral promontory

PELVIC CAVITYExtends downwards and backwards from pelvic inlet,intervenes between inlet and

PELVIC CAVITYAnterior posterior diameter:From middle of the back of symphysis pubis

.Pelvic outletIt is diamond shaped and wider in female.Boundaries In frontLower

Pelvic outlet ( inferior view )

PELVIC OUTLETAnterior –posterior diameter:from lower border of symphysis pubis to tip

Types of pelvisesGynaecoidAnthrapoidAndroidPlatypelloid

GYNAECOID PELVISIdeal pelvis favouring a normal delivery;50.6% of womenBrim slightly ovaltransversely

Male-type pelvis favouring OP positions and apt to cause deep transverse

Ape-like pelvis favouring OP positions often requiring operative vaginal deliveries; 22.7%

PLATYPELLOID PELVISLeads to cephalo-pelvic disproportion; 4.4% of women.Brim oval transversely Sacrum

Asymmetrical pelvises

Clinical Assessment Body build

Engagement defined as the point when the engaging diameter [BPD(biparietal diameter

In Gynaecoid & Android pelvis distance between ischial spine to brim

vaginal examination

Clinical Assessment vaginal examination

vaginal examination

Presentation of the fetus at the time of delivery

CLINICAL ASSESSMENT RADIOLOGICAL EXAMINATIONTRUE AP CONJUGATEOBSTETRIC CONJUGATEMID-CAVITY AP CONJUGATEOUTLET AP CONJUGATEANGLE

Похожие презентации

Derived from latin word means Basin
Ring of bone:
Two hip bone
Sacro-coccygeal part

PELVIC INLET
Pelvic inlet is formed from behind forward by
Sacral promontory
Anterior margins

PELVIC CAVITY
Extends downwards and backwards from pelvic inlet,intervenes between inlet and

PELVIC CAVITY
Anterior posterior diameter:
From middle of the back of symphysis pubis

.
Pelvic outlet
It is diamond shaped and wider in female.
Boundaries In front
Lower

PELVIC OUTLET
Anterior –posterior diameter:
from lower border of symphysis pubis to tip

Types of pelvises
Gynaecoid
Anthrapoid
Android
Platypelloid

GYNAECOID PELVIS
Ideal pelvis favouring a normal delivery;
50.6% of women
Brim slightly ovaltransversely

PLATYPELLOID PELVIS
Leads to cephalo-pelvic disproportion; 4.4% of women.
Brim oval transversely Sacrum

CLINICAL ASSESSMENT RADIOLOGICAL EXAMINATION
TRUE AP CONJUGATE
OBSTETRIC CONJUGATE
MID-CAVITY AP CONJUGATE
OUTLET AP CONJUGATE
ANGLE