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![]() This angle should be at least 90 degrees. One important measurement of the outlet is the angle of the pubic arch. If the ischial spines are prominent and extended into the midpelvis they can reduce the diameter of the midpelvis and might interfere with the journey of the fetus through the passageway during labor. The practitioner takes measurements of the midpelvis at the level of the ischial spines. ![]() An obstetric conjugate that measures 11 cm is considered adequate to accommodate a vaginal delivery. The practitioner then subtracts 1.5 to 2cm from the measurement of the diagonal conjugate to approximate the dimensions of the obstetric conjugate. ![]() To obtain this estimate, the practitioner measures the diagonal conjugate, which extends from the symphysis pubis to the sacral promontory. However the obstetric conjugate cannot be measured directly and therefore the practitioner must estimate the size. The most important measurement of the inlet is the obstetric conjugate because it is the smallest diameter of the inlet through which the fetus must pass. However these measurements don't consistently predict which women will have difficulty delivering vaginally so most practitioners will allow the woman to labor and attempt a vaginal birth. Particularly if the woman has never delivered a baby vaginally, the practitioner may take pelvic measurements to estimate the size of the true pelvis. Therefore women with this pelvis must usually deliver the fetus by cesarean section. This shape makes it extremely difficult for the fetus to pass through. This pelvis is flat in its dimensions with a very narrow anterior-posterior diameter and a wide transverse diameter. The least common type is the platypelloid pelvis. Large babies often become stuck in the birth canal and must be delivered by cesarean, whereas a smaller baby may be able to navigate the narrow diameters. Approximately one third of white women and 16% of non white women have an android pelvis. The Android Pelvis is the typical male pelvis and resembles a heart in its shape. However, a vaginal birth can often be accomplished in approximately one third of women who have variations of this type of pelvis. the anterior-posterior diameter is roomy, but the transverse diameter is narrow compared with that of the gynecoid pelvis. The Anthropoid Pelvis is elongated in its dimensions. This pelvis is considered the typical female pelvis although only about 50% of all women have this type of pelvis. The rounded shape of the gynecoid inlet allows the fetus room to pass through the dimensions of the bony passageway. The Gynecoid pelvis is the most favorable for a vaginal birth. Most women have various combinations of these. ![]() There are four basic pelvic shapes: gynecoid, anthropoid, android, and platypelloid. ![]()
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