Pelvimetry assesses the size of a woman's pelvis aiming to predict whether she will be able to give birth vaginally or not. This can be done by clinical examination, or by conventional X‐rays, computerised tomography (CT) scanning, or magnetic resonance imaging (MRI).

What is clinical Pelvimetry?

Clinical pelvimetry attempts to assess the pelvis by clinical examination. ... This is also called the obstetric anteroposterior diameter of the pelvic outlet, to distinguish from the anatomic one which includes the coccyx. However, the coccyx is normally pushed away during childbirth by laxity in the sacrococcygeal joint.

How do you examine pelvic adequacy?

1. Diagonal conjugate. Distance from sacral promontory to Symphysis Pubis. Approximate length of fingers introitus to Sacrum. Adequate Diagonal conjugate > 11.5cm. ...
2. Intertuberous Diameter. Distance between Ischial tuberosities. Approximately width of fist. ...
3. Prominence of ischial spines.

How do you measure the pelvic diameter?

It is measured between the outer edge of the upper edge of the pubis and the posterior external point at the first sacral segment (Figure ​ 2I). The anteroposterior distance of the pelvic inlet is between the upper edge of the pubic symphysis and the sacral promontory (the first segment of the sacrum).

How do you measure obstetric conjugate clinically?

The obstetric conjugate: Measured from the sacral promontory to the point bulging the most on the back of the symphysis pubis, located about 1 cm below its upper border. It measures 10.5 cm on average; it is the lesser anteroposterior diameter.

Clinical Pelvimetry

What is the pubic arch?

: the notch formed by the inferior rami of the two conjoined pubic bones as they diverge from the midline.

How do you find the true conjugate?

In order to find the true conjugate one has to subtract 1.5—2 cm from the diagonal conjugate depending on the circumference of the radiocarpal articulation: if the circumference makes 15 cm — 1.5 cm, if it makes 16 cm and more — 2 cm.

What are the 3 diameters of the pelvic outlet?

• Antero - posterior diameters: Anatomical antero-posterior diameter =11cm. from the tip of the coccyx to the lower border of symphysis pubis. Obstetric antero-posterior diameter = 13 cm. ...
• Transverse diameters: Bituberous diameter = 11 cm. between the inner aspects of the ischial tuberosities. Bispinous diameter = 10.5 cm.

What are the 4 types of pelvis?

Although pelvises can be classified according to diameter, in obstetric practice they are often divided into 4 main types: gynecoid, android, anthropoid, and platypelloid, based mainly on the shape of the pelvic inlet [5].

How do you perform a cervical exam?

During the exam, a device called a speculum will be inserted into the vagina. The speculum is opened to widen the vagina so that the vagina and cervix can be seen. Perform a Pap smear. Your doctor will use a plastic spatula and small brush to take a sample of cells from the cervix.

How do you perform a bimanual exam?

1. Technique. Place your other hand midway between the umbilicus and the symphysis pubis and press downward toward the pelvic hand. Using the palmar surface of your fingers, palpate for the uterine fundus while gently pushing the cervix anteriorly with the pelvic hand.
2. Feel the uterus and note. Size. Position.

How do you perform cervical motion tenderness?

Assess for cervical motion tenderness by gently moving cervix back and forth. position. quadrant of the abdomen on the same side and attempt to palpate the ovary, check for Page 3 pelvic masses. Move vaginal fingers into the other lateral fornix and abdominal hand to same side and repeat exam.

When do you do pelvimetry?

A pregnant mother or her caregiver might be worried that disproportion could occur and for this reason, pelvimetry can be performed either before or during labour. It can be undertaken by clinical examination, X-ray, CT-scan or MRI. Pelvimetry measures the diameters of the pelvis and the baby's head.

What is pelvimetry xray?

X-ray pelvimetry is used to assess the dimensions of the maternal pelvis. It is usually performed in the late stages of pregnancy in cases of suspected cephalopelvic dispro- portion or breech presentation, or post partum in patients who have had a previous caesarean section.

What is the McRoberts position?

McRoberts' manoeuvre consists of sharp flexion of patients' hips against the abdomen, and is effective in 40–80% of patients when used as either the primary or the sole position. It is used as the first step towards an emergent vaginal delivery after diagnosis of impacted fetal shoulders.

How do you open your pelvis?

Coming into a wide leg squat position helps open the pelvis, and gravity will naturally promote lengthening in the pelvic floor. This is best performed as a repetitive exercise instead of a position that is held. Step your feet wider then your hips, with your feet angled out slightly.

What are the abnormalities of pelvis?

• Pelvic organ prolapse. ...
• Vesicovaginal fistula, urethrovaginal fistula, ureterovaginal fistula, rectovaginal fistula. ...
• Incontinence. ...
• Overactive bladder. ...
• Female sexual function. ...
• Urethral diverticulum.

What is pelvis function?

The pelvis plays important functions in (1) locomotion, as body weight is transmitted to the lower limbs through the pelvic girdle, (2) childbirth, as the human neonate must pass through the birth canal, which lies within the pelvic girdle as the baby exits the body, and (3) support of abdominal organs which are held ...

What is a pelvic outlet?

The pelvic outlet is the inferior opening of the pelvis that is bounded by coccyx, the ischial tuberosities, and the pubis symphysis.

What is the landmark in the pelvic outlet?

3 The pelvic outlet. The pelvic outlet is formed by the lower border of the pubic bones at the front, and the lower border of the sacrum at the back. The ischial spines point into this space on both sides.

What are the boundaries of the Midpelvis?

The midpelvis, including the planes of greatest and least pelvic diameters, is bounded anteriorly by the posterior aspect of the symphysis pubis and posteriorly by segments of the sacrum at lev- el S3 or S4. The pelvic side walls and ischial spines form the lateral boundaries of the midpelvis [9] .

What is the fetal skull?

The fetal skull bones are as follows: The frontal bone, which forms the forehead. In the fetus, the frontal bone is in two halves, which fuse (join) into a single bone after the age of eight years. The two parietal bones, which lie on either side of the skull and occupy most of the skull.

What is the normal fetal presentation?

Normally, the position of a fetus is facing rearward (toward the woman's back) with the face and body angled to one side and the neck flexed, and presentation is head first. An abnormal position is facing forward, and abnormal presentations include face, brow, breech, and shoulder.

What is the plane of greatest pelvic dimension?

The plane extending from the middle of the posterior surface of the pubic symphysis to the junction of the second and third sacral vertebrae, passing laterally through the ischial bones over the middle of the acetabulum.