BONES COMPOSE THE BONY PELVIS Ilium Ischium Pubis Sacrum Coccyx

TWO DIVISIONS OF THE PELVIS 1. FALSE PELVIS upper larger divisions that supports the uterus in the abdominal cavity. 2. TRUE PELVIS lower smaller portion, the canal through which the baby must pass.

PELVIS
ANDROID PELVIS male pelvis The pubic arch in this pelvis forms an acute angle, making the lower dimensions of the pelvis extremely narrow. Has prominent ischial spines and convergent sidewalls.

A fetus may have difficulty exiting from this type of pelvis. May result to forceps delivery or CS.

ANTHROPOID PELVIS ape like pelvis The transverse diameter is narrow and the anteroposterior diameter of the inlet is larger than normal. Heart shaped pelvis

This does not accommodate a fetal head as well as a gynecoid pelvis.

GYNECOID PELVIS normal female pelvis. Found in approximately 50% of women. The inlet is well rounded forward and backward; the pubic arch is wide. The ischial spines are not usually prominent. This pelvic type is ideal for childbirth.

PLATYPELLOID PELVIS flattened pelvis. The inlet is an oval, smoothly curved, but the anteroposterior diameter is shallow. A fetal head might not be able to rotate to match the curves of the pelvic cavity in this type of pelvis.

INTERNAL PELVIC MEASUREMENTS

DIAGONAL CONJUGATE is the distance between the anterior surface of the sacral prominence and the anterior surface of the inferior margin of the symphysis pubis. Most useful measurement for estimation of pelic size, it suggest the anteroposterior diameter of the pelvic inlet. It is measured while the woman is in a lithotomy position. To measure it, two fingers are introduced vaginally and pressed inward and upward until the middle finger touches the sacral prominence. With the other hand, the part of the examining hand where it touches the symphysis pubisis marked. After withdrawing the examining hand, the distance between the tip of the middle finger and the marked point on the glove on that hand is measured by comparing it with a ruler or for greater accuracy, a PELVIMETER. Warn the client that the measurement may be slightly painful. If measurement obtained is 12.5 cm or more, the pelvic inlet is rated as adequate for childbirth. (average diameter of fetal head that must pass that point averages 9cm in diameter)

TRUE CONJUGATE or CONJUGATE VERA- is the measurement between the anterior surface of the sacral prominence and the posterior surface of the inferior margin of the symphysis pubis This measurement cannot be made directly. To do this subtract 1.5- 2cm from the diagonal conjugate measurement. The distance remaining will be the true conjugate or the actual diameter of the pelvic inlet through which the fetal head must pass.

ISCHIAL TUBEROSITY DIAMETER is the distance between the ischial tuberosities or the transverse diameter of the outlet . It is made at the medial and lowermost aspect of the ischial tuberosities at the level of the anus. A pelvimeter is generally used but also can be made using ruler. A diameter of 11cm is considered adequate because it will allow the widest diameter of the fetal head (9cm) to pass freely through the outlet.