Accurate determination of the size of the pelvis in obstetrics before the onset of labor can save the life of the mother and child. Every woman goes through this procedure, since with its help you can understand in advance whether a caesarean section is required. In gynecology, the sizes of the large and small pelvis are measured; each distance has its own name and standards. To carry out the procedure, a special instrument is used - a medical metal compass - a tazometer.
Basic parameters of the large pelvis
Female pelvis significantly different in size from men's. It is important for a girl to know several parameters and their meanings to make sure that doctors are acting correctly:
- The spinarum distance is normally 25-26 cm - this is the distance between the anterosuperior spines of the bones of the iliac zone.
- The cristarum distance – normally 28-29 cm – is the position of the distant promontories of the iliac crests, located above the attachment of the hip joint.
- External conjugate - from 20 to 21 cm - the distance from the middle of the top of the symphysis to the upper corner of the Michaelis rhombus.
An awn is an acute formation on the bones, which is diagnosed both normally and with various diseases. Osteophytes and osteoporosis are derivatives of this word.
Narrowing of the female pelvis is a common problem in obstetrics. This indicator matters:
- at grade 1 - the mildest - the true conjugate retains a size greater than 9, but less than 11 cm;
- with degree 2 narrowing of the pelvis, this figure is 7 and 9 cm, respectively;
- at grade 3 – 5 and 7 cm;
- at grade 4, the true conjugate barely reaches 5 cm.
The true conjugate of the pelvis is the distance from the protruding part of the sacrum to the superior promontory of the pubic symphysis at the exit. The easiest way to determine the parameter is by the dimensions of the conjugates on the outside.
A true conjugate is the smallest distance inside through which the fetus emerges during childbirth. If the indicator is less than 10.5 cm, then natural childbirth Doctors forbid it. The true conjugate parameter is established by subtracting 9 cm from the external indicator.
The diagonal conjugate is the distance from the bottom of the symphysis pubis to the prominent point of the sacrum. It is determined using vaginal diagnostics. At normal pelvis the indicator does not exceed 13 cm, sometimes it is at least 12 cm. To clarify the true conjugate, 1.5-2 cm is subtracted from the resulting figure.
When examining the diagonal indicator, the doctor in rare cases reaches the promontory of the sacrum with his fingers. Usually, if the bone is not felt when you place your fingers inside the vagina, the size of the pelvis is considered normal.
The shape of the pelvis can affect normal indicators. With a platipeloid constitution, which occurs in 3% of women, the pelvis is elongated and slightly flattened. In this case, the gap between the bones narrows, as a result of which the birth process can be complicated.
Pelvic planes
To understand the exact characteristics of the female skeleton, it is necessary to measure the plane before giving birth:
- Entrance plane. In front, it starts from the top of the symphysis and reaches behind the promontory, and the lateral distance is bordered by the innominate line. The direct size of the entrance corresponds to the true conjugate - 11 cm. The transverse size of 1 plane is between distant points of the boundary lines, not less than 13 cm. The oblique sizes start from the sacroiliac joint and continue to the pubic tubercle - from 12 to 12.5 cm normally. The entrance plane usually has a transverse oval shape.
- Plane of the wide part. It runs through the inner surface of the womb strictly in the middle, passes along the sacrum and projection acetabulum. It has a round shape. The straight size is measured, which is normally 12.5 cm. It starts from the middle of the pubic symphysis and extends to the 2nd and 3rd vertebrae of the sacrum above the buttocks. The transverse size of the zone is 12.5 cm, measured from the middle of one plate to the other.
- Plane of the narrow part. It starts from the bottom of the symphysis and reaches behind the sacrococcygeal joint. On the sides the plane is limited by the ischial spines. The straight size is 11 cm, the transverse size is 10 cm.
- Exit plane. It connects the lower edge of the symphysis with the edge of the coccyx at an angle, along the edges it goes into the ischiums located in the buttocks area. The direct size is 9.5 cm (if the tailbone is deviated, then 11.5 cm), and the transverse size is 10.5 cm.
In order not to get confused in all the indicators, you can pay attention only to the measurement large pelvis. The table shows an additional parameter - the distance between the trochanters of the femurs.
Spit femur located at the point where girls usually measure their hip volume.
Determining the size of the pelvis: narrow or wide
By comparing the obtained indicators, it is easy to determine whether a woman has wide or narrow hips. After consulting with a gynecologist and determining whether the size of the female pelvis is normal, you can decide whether to have a caesarean section or give birth on your own.
Indicators are higher than normal
In most cases, a wide female pelvis is a good factor for pregnancy. Girls should understand that if a woman loses weight, the pelvis cannot become narrower because of this - everything is inherent in the structure of the bones. Wide hips most often found in large women, and this cannot be considered a pathology. If the dimensions exceed the norm by 2-3 centimeters, this is considered a wide pelvis.
The main danger of too wide hips is rapid labor. In such a situation, the child passes much faster through the birth canal, which can lead to female injuries: rupture of the cervix, vagina and perineum.
Anatomically narrow pelvis
The definition of an anatomically narrow pelvis in obstetrics is closely related to normal indicators. A deviation of 1.5 cm from the minimum limit indicates that the woman has small hips. In this case, the conjugate should be less than 11 cm. Natural birth in this case is possible only when the child is small.
When diagnosing, the doctor identifies the type of pelvis: transversely narrowed, uniformly narrowed, flat, simple or rachitic. Less common are pathological forms in which the pelvis begins to narrow pathological changes in the bone structure: kyphotic, deformed, obliquely displaced or spondylolistetic pelvis. Causes of anatomically narrow pelvis:
- bone injuries;
- rickets;
- elevated physical exercise and lack proper nutrition in childhood;
- neoplasms in the study area;
- hyperandrogenism, leading to male type formation;
- accelerated growth during adolescence;
- psycho-emotional stress that caused compensatory development in childhood;
- general physiological or sexual infantilism;
- Cerebral palsy, birth injuries, polio;
- professional sports;
- metabolic problems;
- dislocations of the hip joints;
- inflammatory or infectious diseases skeletal system;
- rachiocampsis.
Factors that provoke improper formation of the pelvis include: hormonal imbalance, constant colds and problems with the menstrual cycle.
Clinically narrow pelvis
Clinically, a narrow pelvis can be identified only before childbirth, or during the process of delivery. This is due to the discrepancy between the size of the fetus and the woman’s birth canal. For example, if the child’s weight is more than 4 kg, even a girl with normal indicators. There is no single answer to the question of why this condition is formed. The doctor identifies a whole range of reasons:
- large fruit;
- post-term for more than 40 weeks;
- malposition;
- tumors of the uterus or ovaries;
- fetal hydrocephalus (enlarged head);
- fusion of the vaginal walls;
- breech presentation of the fetus (the baby is turned with the pelvis instead of the head).
IN obstetric practice There are more and more cases of clinically narrow birth canal because large children are born.
Every woman should know her pelvic parameters before giving birth. A responsible gynecologist never ignores these indicators and carefully conducts the examination using an obstetric caliper.
The pelvis consists of four bones: two pelvic (nameless), the sacrum and the coccyx. Until 16-18 years of age, the pelvic bone consists of 3 bones connected by cartilage: ilium, ischium and pubis. After ossification of the cartilage, a single innominate bone is formed.
There are large and small pelvises. The border between the large and small pelvis is the boundary line. The large pelvis is available for research and has 4 main sizes:
1. Distantia Spinarum - the distance between the anterosuperior iliac spines is normally 25-26 cm.
2. Distantia Cristarum - the distance between the most distant points of the iliac crests is normally 28-29 cm.
3. Distantia Trochanterica - distance between large skewers thigh bones, normally 30-31 cm.
4. Conjugata Externa (external conjugate) - the distance between the upper outer edge of the symphysis and the suprasacral fossa is normally 20-21 cm.
There are 4 planes in the small pelvis:
Entry plane;
The plane of the wide part;
The plane of the narrow part;
Exit plane.
One of the main dimensions of the small pelvis is the direct inlet size or true conjugate. This is the distance from the upper outer edge of the symphysis to the sacral promontory, which is normally 11 cm. The dimensions of the small pelvis cannot be measured. The size of the large pelvis is usually used to judge the size of the small pelvis.
Differences between the female pelvis and the male pelvis begin to emerge during puberty and become distinct in adulthood:
The bones of the female pelvis are thinner, smoother and less massive than the bones of the male pelvis;
The female pelvis is lower, wider and larger in volume;
The sacrum in women is wider and not as strongly concave as in the male pelvis;
The sacral promontory in women protrudes forward less than in men;
The symphysis of the female pelvis is shorter and wider;
The entrance to the pelvis in a woman is wider, the shape of the entrance is transverse-oval, with a notch in the area of the promontory; entrance to male pelvis resembles a card heart due to the sharper protrusion of the cape;
The pelvic cavity in women is larger, its outlines approaching a cylinder, curved anteriorly; the cavity of the male pelvis is smaller, it narrows funnel-shaped downwards;
The outlet of the female pelvis is wider because the distance between the ischial tuberosities is greater, the pubic angle is wider (90-100°) than in men (70-75°); The tailbone protrudes anteriorly less than in the male pelvis. So, the female pelvis is more voluminous and wider, but less deep than the male pelvis. These features are important for the birth process.
In the small pelvis there are the following sections: inlet, cavity and outlet. In the pelvic cavity there are wide and narrow part. In accordance with this, four planes of the pelvis are considered: I – the plane of the entrance to the pelvis, II – the plane of the wide part of the pelvic cavity, III – the plane of the narrow part of the pelvic cavity, IV – the plane of the exit of the pelvis.
I. The plane of the entrance to the small pelvis, boundaries: in front - the upper edge of the symphysis and the upper inner edge of the pubic bones, on the sides - innominate lines, behind - the sacral promontory. At the entrance to the pelvis there are three sizes: straight, transverse and two oblique.
Straight size - the distance from the sacral promontory to the most prominent point on the inner surface of the pubic symphysis. This size is called the obstetric, or true, conjugate (conjugata vera). There is also an anatomical conjugate - the distance from the promontory to the middle of the upper inner edge of the symphysis; the anatomical conjugate is slightly (0.3-0.5 cm) larger than the obstetric conjugate. Obstetric, or true conjugate is 11 cm.
Transverse dimension is the distance between the most distant points of nameless lines. This size is 13-13.5 cm.
There are two oblique sizes: right and left, which are equal to 12-12.5 cm. The right oblique size is the distance from the right sacroiliac joint to the left iliopubic tubercle, the left oblique dimension is from the left sacroiliac joint to the right iliopubic tubercle tubercle In order to more easily navigate in the direction of the oblique dimensions of the pelvis in a woman in labor, M.S. Malinovsky and M.G. Kushnir is offered next appointment. The hands of both hands are folded at right angles, with the palms facing upward; the ends of the fingers are brought closer to the outlet of the pelvis of the lying woman. The plane of the left hand will coincide with the left oblique size of the pelvis, the plane of the right hand will coincide with the right.
II. The plane of the wide part of the pelvic cavity, boundaries: in front - the middle of the inner surface of the symphysis, on the sides - the middle of the acetabulum, in the back - the junction of the II and III sacral vertebrae. In the wide part of the pelvic cavity, two sizes are distinguished: straight and transverse.
Direct size - from the junction of the II and III sacral vertebrae to the middle of the inner surface of the symphysis; equals 12.5 cm.
Transverse size - between the apices of the acetabulum; equals 12.5 cm.
There are no oblique dimensions in the wide part of the pelvic cavity because in this place the pelvis does not form a continuous bone ring. Oblique dimensions in the widest part of the pelvis are conditionally allowed (length 13 cm).
III. The plane of the narrow part of the pelvic cavity is limited in front by the lower edge of the symphysis, on the sides by the spines of the ischial bones, and behind by the sacrococcygeal joint. There are two sizes: straight and transverse.
The straight dimension goes from the sacrococcygeal joint to the lower edge of the symphysis (apex of the pubic arch); equal to 11-11.5 cm.
The transverse dimension connects the ischial spines; equal to 10.5 cm.
IV. The plane of exit of the small pelvis has the following boundaries: in front - the lower edge of the symphysis, on the sides - the ischial tuberosities, in the back - the apex of the coccyx. The exit plane of the pelvis consists of two triangular planes, the common base of which is the line connecting the ischial tuberosities. There are two sizes of the pelvic outlet: straight and transverse.
The direct size of the pelvic outlet goes from the apex of the coccyx to the lower edge of the symphysis; it is equal to 9.5 cm. When the fetus passes through the small pelvis, the tailbone moves away by 1.5-2 cm and the direct size increases to 11.5 cm.
The transverse size of the pelvic outlet connects internal surfaces ischial tuberosities; equal to 11 cm. Thus, at the entrance to the pelvis, the largest dimension is the transverse one. In the wide part of the cavity, the straight and transverse dimensions are equal; the largest size will be the conventionally accepted oblique size. In the narrow part of the cavity and the pelvic outlet, the straight dimensions are larger than the transverse ones.
There are two sections of the pelvis: the large pelvis and the small pelvis. The boundary between them is the plane of the entrance to the small pelvis.
The large pelvis is bounded laterally by the wings of the ilium, and posteriorly by the last lumbar vertebra. In front it has no bony walls.
The small pelvis is of greatest importance in obstetrics. The birth of the fetus occurs through the small pelvis. There are no simple ways to measure the pelvis. At the same time, the dimensions of the large pelvis are easy to determine, and on their basis one can judge the shape and size of the small pelvis.
The pelvis is the bony part of the birth canal. The shape and size of the small pelvis are very important during childbirth and determining the tactics of its management. With sharp degrees of narrowing of the pelvis and its deformations, childbirth through natural birth canal become impossible, and the woman is given birth through surgery caesarean section.
The posterior wall of the pelvis is made up of the sacrum and coccyx, the lateral ones are the ischial bones, and the anterior wall is made up of the pubic bones with the pubic symphysis. Top part The pelvis is a continuous bony ring. In the middle and lower thirds the walls of the small pelvis are not solid. In the lateral sections there are greater and lesser sciatic foramina, bounded respectively by the greater and lesser sciatic notches and ligaments. The branches of the pubic and ischial bones, merging, surround the obturator foramen, which has the shape of a triangle with rounded corners.
In the small pelvis there are an entrance, a cavity and an exit. In the pelvic cavity there are wide and narrow parts. In accordance with this, four classic planes are distinguished in the small pelvis.
The plane of entrance to the small pelvis is limited in front by the upper edge of the symphysis and the upper inner edge of the pubic bones, on the sides by the arcuate lines of the ilium and behind by the sacral promontory. This plane has the shape of a transverse oval (or kidney-shaped). It has three sizes: straight, transverse and 2 oblique (right and left). The direct dimension is the distance from the superior inner edge of the symphysis to the sacral promontory. This size is called the true or obstetric conjugate and is equal to 11 cm.
In the plane of the entrance to the small pelvis, an anatomical conjugate is also distinguished - the distance between the upper edge of the symphysis and the sacral promontory. The size of the anatomical conjugate is 11.5 cm. The transverse size is the distance between the most distant sections of the arcuate lines. It is 13.0-13.5 cm.
The oblique dimensions of the plane of entrance to the small pelvis are the distance between the sacroiliac joint of one side and the iliopubic eminence of the opposite side. The right oblique size is determined from the right sacroiliac joint, the left - from the left. These sizes range from 12.0 to 12.5 cm.
The plane of the wide part of the pelvic cavity is limited in front by the middle of the inner surface of the symphysis, on the sides by the middle of the plates covering the acetabulum, and behind by the junction of the II and III sacral vertebrae. In the wide part of the pelvic cavity there are 2 sizes: straight and transverse.
Direct size - the distance between the junction of the II and III sacral vertebrae and the middle of the inner surface of the symphysis. It is 12.5 cm.
Transverse size is the distance between the middles of the internal surfaces of the plates covering the acetabulum. It is equal to 12.5 cm. Since the pelvis in the wide part of the cavity does not represent a continuous bone ring, oblique dimensions in this section are allowed only conditionally (13 cm each).
The plane of the narrow part of the pelvic cavity is limited in front by the lower edge of the symphysis, on the sides by the spines of the ischial bones, and behind by the sacrococcygeal joint. In this plane there are also 2 sizes.
Straight size - the distance between the lower edge of the symphysis and the sacrococcygeal joint. It is equal to 11.5 cm.
Transverse size - the distance between the spines of the ischial bones. It is 10.5 cm.
The plane of exit from the small pelvis is limited in front by the lower edge of the pubic symphysis, on the sides by the ischial tuberosities, and behind by the apex of the coccyx.
Straight size - the distance between the lower edge of the symphysis and the tip of the coccyx. It is equal to 9.5 cm. When the fetus passes through the birth canal (through the plane of exit from the small pelvis), due to the posterior movement of the coccyx, this size increases by 1.5-2.0 cm and becomes equal to 11.0-11.5 cm .
Transverse size - the distance between the inner surfaces of the ischial tuberosities. It is equal to 11.0 cm.
When comparing the sizes of the small pelvis in different planes, it turns out that in the plane of the entrance to the small pelvis the maximum are transverse dimensions, in the wide part of the pelvic cavity, the direct and transverse dimensions are equal, and in the narrow part of the cavity and in the plane of exit from the small pelvis, the direct dimensions are larger than the transverse ones.
In obstetrics, in some cases, the system of parallel Goji planes is used. The first, or upper, plane (terminal) passes through the upper edge of the symphysis and the border (terminal) line. The second parallel plane is called the main plane and runs through the lower edge of the symphysis parallel to the first. The fetal head, having passed through this plane, does not subsequently encounter significant obstacles, since it has passed through a solid bone ring. The third parallel plane is the spinal plane. It runs parallel to the previous two through the spines of the ischial bones. The fourth plane, the exit plane, runs parallel to the previous three through the apex of the coccyx.
All classic planes of the pelvis converge anteriorly (symphysis) and fan out posteriorly. If you connect the midpoints of all straight dimensions of the small pelvis, you will get a line curved in the shape of a fishhook, which is called wire axis pelvis It bends in the pelvic cavity according to the concavity of the inner surface of the sacrum. The movement of the fetus along the birth canal occurs in the direction of the pelvic axis.
The pelvic inclination angle is the angle formed by the plane of the entrance to the pelvis and the horizon line. The angle of inclination of the pelvis changes as the center of gravity of the body moves. In non-pregnant women, the pelvic inclination angle is on average 45-46°, and lumbar lordosis is 4.6 cm (according to Sh. Ya. Mikeladze).
As pregnancy progresses, lumbar lordosis increases due to a shift in the center of gravity from the area of the II sacral vertebra anteriorly, which leads to an increase in the angle of inclination of the pelvis.
During pregnancy, the size of the pelvis plays an important role. Sometimes the course of labor depends on this. If the pelvic bones are narrow, complications may arise during childbirth or result in a caesarean section. A narrow pelvis is observed in approximately 3% of women during pregnancy, but it is not always an indicator for cesarean section.
When registering for pregnancy, the female pelvis is given Special attention. After measuring it, the gynecologist will be able to predict at the very beginning of pregnancy how the birth will proceed.
Distinguish anatomical And clinical narrow pelvis during pregnancy.
Anatomical narrow pelvis- discrepancy of at least one parameter by 1.5-2 cm or more from normal. It is a consequence of the influence of certain factors on the body in childhood: poor nutrition, frequent infectious diseases, lack of vitamins, hormonal disorders during puberty, congenital anomalies, injuries and fractures. Also, deformation of the pelvic bones can occur as a result of tuberculosis, rickets, and polio.
If a pregnant woman is diagnosed with 1 degree of narrowing out of 4, then childbirth naturally quite possible. It is also possible to give birth independently even with 2nd degree of contraction, but taking into account certain conditions, for example, if the fetus is not large. The remaining degrees (3 and 4) are always an indication for cesarean section.
Clinical narrow pelvis- discrepancy between the fetal head and the parameters of the mother’s pelvis, diagnosed during childbirth. IN in this case the pelvis has normal physiological parameters and shape. It is considered narrow because the fetus is quite large or is not presented correctly on the forehead or face. For this reason, the child cannot be born naturally.
Normal pelvic sizes
The pelvis is measured with a special instrument, a pelvis meter, which measures:
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Distance between front upper corners iliac pelvic bones. Normally it is 25-26 cm. |
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The distance between the most distant points of the iliac crests. Normally it is 28-29 cm. |
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The distance between the greater trochanters of the femurs. Normally it is 31-32 cm. |
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The distance from the middle of the upper outer edge of the symphysis to the suprasacral fossa. Normally it is 20-21 cm. |
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Michaelis rhombus (lumbosacral rhombus). Normally, its diagonal value is 10 cm, vertically - 11 cm. If there is asymmetry or its parameters are smaller normal values, then this indicates an abnormal structure of the pelvic bones. |
Additionally, it is possible to obtain data on the parameters of the pelvic bones using the following studies:
- X-ray pelviometry. Carrying out this study allowed at the end of the third trimester, when all tissues and organs of the fetus are already formed. Thanks to the procedure, you can find out the shape of the bones and sacrum, determine the direct and transverse dimensions of the pelvis, measure the fetal head and determine whether it corresponds to its parameters.
- Ultrasonography . An ultrasound can determine the correspondence of the size of the fetal head with the size of the pelvic bones. The procedure also allows you to find out the location of the fetal head, since in cases of frontal or facial presentation during childbirth, it will need more space.
- Solovyov index- circumference measurement wrist joint women, thanks to which you can find out the thickness of the bones and determine the direct size of the cavity of the entrance to the pelvis. Normally, the circumference of the wrist joint is 14 cm. If it is larger, then the bones are massive; if smaller, then the bones are thin. For example, with insufficient external dimensions of the pelvic bones and with a normal Solovyov index, the dimensions of the pelvic ring are sufficient for a child to pass through it.
Childbirth with a narrow pelvis and possible complications
IN antenatal clinic All pregnant women with a narrow pelvis are on special registration. It is very important, in this case, to determine the date of birth, since post-term pregnancy is extremely undesirable. The woman will be admitted to the maternity hospital in 1-2 weeks. Closer to the due date, doctors will decide on the method of delivery.
During natural childbirth with a narrow pelvis, there is a high risk of developing complications in the fetus (breathing disorders, oxygen starvation, birth trauma, impaired blood circulation in the brain, clavicle fracture, damage to the skull bones and, worst of all, intrauterine death) and the mother (weak labor, premature rupture of amniotic fluid, postpartum infection, threat of uterine rupture).
Views: 28164 .Become very important during pregnancy anatomical features female body. Future mom must carry and give birth to a baby without serious consequences for your health.
The size of the pelvis during pregnancy plays a huge role in the process of natural childbirth. That is why these indicators are determined by obstetricians when caring for a pregnant woman.
Pelviometry
During an external obstetric examination, a manipulation called pelviometry is performed. Literally this term is translated as pelvic measurement.
Pelviometry is performed using special device– Martin pelvis gauge. This instrument consists of two legs, which are connected by a special scale. Using the latter, the doctor determines the distance between the apart legs of the device.
The pelvis gauge is installed on the bony protrusions of a pregnant woman and the doctor quickly receives information about the required dimensions.
The pelviometry procedure is absolutely painless and takes a few minutes.
Normal indicators
During pelviometry, a specialist can determine several different values. Highest value have only 5 indicators:
- First, Distantia spinarum is identified. The bony pelvis has four most prominent sections - the iliac spines. This indicator means the segment between the anterior upper most protruding points of the pelvis on both sides.
- Next, the doctor identifies Distantia cristarum. This indicator means the distance between the most distant parts of the pelvic crests. To determine its legs, the pelvis meter moves along the ridge until the greatest distance between them.
- The following parameter indirectly allows us to judge the size of the cavity. Distantia trochanterica represents the length of the distance between the greater trochanters of the femur. These bony prominences are easily felt in most people.
- Conjugata externa is determined in a woman lying on her side. In this case, one leg of the pelvis is installed at the junction of the lower back with the sacrum, and the second on the upper edge of the pubic symphysis. This parameter has an auxiliary value and helps determine the true conjugate.
- The most important role is played by the true conjugate. It is determined arithmetically. 9 centimeters are subtracted from the external size. However, in some women the bones are thicker; if the circumference of the patient’s wrist exceeds 15 centimeters, then 10 centimeters must be subtracted from the size of the external conjugate.
As a result of measurements, 5 main sizes are determined, which correspond to the norm.
Pelvic dimensions during pregnancy, normal – table:
Normal pelvic size allows a woman to carry and give birth to a healthy baby without complications. Clinical significance
If bone structures are less than normal, this can lead to the following consequences:
- Premature rupture of amniotic fluid. The increasing volume of amniotic fluid begins to exceed the capacity of the bony pelvis. As a result, the shells rupture and liquid pours out.
- Loss of fetal parts during pushing.
- Difficulty in the passage of the fetus during childbirth.
- Hypoxia of a child with the development of complications of oxygen starvation.
- Bleeding, fractures, hematomas and other types of birth injuries.
- Inflammation of the membranes.
- Ruptures of the perineum, vagina and cervix.
- Anomalies labor activity in the form of weakness or incoordination.
- Obstetric postpartum hemorrhage.
To prevent these complications, it is necessary to detect pathology of bone structures in time.
Anatomically narrow pelvis
In obstetrics, the concept of a narrow pelvis is divided into anatomical and clinical options. In the first case, there is a decrease in the size of the bone pelvis below the norm presented above. In the second, the size of the fetus does not correspond to the patency of the birth canal.
Anatomically narrow pelvis can manifest itself in the following ways:
- Transversely narrowed - only those indicators that determine the transverse volume of the cavity are reduced.
- Flat – the direct dimensions of bone structures are reduced.
- Generally uniformly narrowed - all indicators are less than normal, but the shape of the bones is correct.
- Oblique - the bones on the left and right have different sizes, so the cavity is asymmetrically curved.
- Pelvis narrowed by tumors and exostoses. Special shape pathology in which individual formations reduce the size of the bone cavity.
The listed pathology options can develop under the influence of such factors:
- Improper nutrition of women.
- Shortening of one lower limb.
- Viral polio.
- Tuberculosis of the bones of the lower extremities.
- Fractures and other skeletal injuries.
- Rickets and osteoporosis.
- Excessive physical activity.
- Hereditary characteristics.
Clinically narrow pelvis
The concept of a clinically narrow pelvis has a slightly different meaning. This condition can also be observed when normal sizes bones, but the fruit is too large.
This condition is determined only at the moment of the onset of labor. Before this, it is not possible to make such a diagnosis. With this pathology the following symptoms are observed:
- Excessive pushing when the presenting part is standing high.
- Unsynchronized opening of the cervix with the advancement of the fetus.
- Contractions are painful and unproductive.
- Edema subcutaneous tissue in the area of the external genitalia.
- Lack of urination.
- Pain in the lower abdomen.
- Fetal tachycardia.
A confirmed diagnosis may be an indication for a cesarean section, since natural childbirth can lead to serious complications.
The clinical significance of the pelvic bone parameters is very high, so pelvimetry is performed on every pregnant woman.
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