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Sacral promontory
Iliopectineal line
Sacrospinous ligament
Ischial tuberosity
Sacrum
Coccyx
It is formed by the sacral promontory, ala of the sacrum, arcuate line of the ilium, iliopubic eminence, pictineal line of the pubis, pubic crest & symphesis pubis
The plane of the brim is 55-60 above the horizontal
The pelvic cavity The pelvic canal is curved , the post wall is longer than the anterior
The most roomy zone with almost round shape TD---13.5 APD----12.5
APD ----- lower border of the symphysis pubis to last fixed point of the sacrum----- 12-12.5 cm
TD ----- between the ischial spines ------ 10-10.5 cm
PELVIC SHAPE
1-GYNECOID
PELVIC SHAPE
2-ANDROID
PELVIC SHAPE
3-ANTHROPOID 25% white women & 50% nonwhite Pelvic brim APD > TD Long & narrow pelvic canal with long sacrum Straight pelvic sidewalls 4-PLATYPELLOID 3% of women Pelvic brim TD >>>APD kidney shape Sacral promontory pushed forwards
PELVIC WALLS
The inner aspect of the bony pelvis is covered with muscles Above the brim --- iliacus & psoas Sidewalls ---- obturator internus & its fascia Post wall ---- pyriformis
PELVIC LIGAMENTS Ligaments Sacrospinous ligament lateralaspect of the sacrum to ischial spines Sacrotuberous ligament lateral aspect of the sacrum to inner aspect of ischial tuberosity Sacroiliac ligament medial surface of the ilium to sacrum lliolumbar ligament iliac crest to transv lumbar vertebra
ADEQUACY OF THE PELVIS TO ACHIEVE VAGINAL DELIVERY WHAT IS THE OBSTETRIC CONJUGATE?
ADEQUACY OF THE PELVIS TO ACHIEVE VAGINAL DELIVERY WHAT IS THE TRUE CONJUGATE? APD between promontory of the sacrum & superior margin of the symphysis pubis
FETAL SKULL
The skull is formed of the face , the vault & the base
The bones that form the skull are : two frontal bones, two parietal bones, two temporal bones wings of the sphenoid & occipital bone The bones of the face & base are heavy & fused
The bones of the vault are 2 frontal ,2 parietal & occipital The bones of the vault are not joined thus changes in the shape of the fetal head during labor can occur due to molding
Bregma Ant fontanelle Brow lies between bregma &root of the nose Face lies between root of the nose & suborbital ridges Occiput boney prominence behind post fontanelle Vertex diamond shaped area between ant & post fontanelles & parietal eminences
Post font (lambda) triangle shaped space between sagittal & lambdoid suture