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True pelvis is made up of the pelvic brim, pelvic cavity, and pelvic outlet: - pelvic brim superior circumference forms the brim - pelvic cavity b/w brim and outlet; depth of 4cm; contains the colon, rectum, bladder, and some of the reproductive organs - pelvic outlet lower circumference; -->anatomical outlet formed by the lower borders of the bones together with the sacrotuberous ligament --> obstetrical outlet includes the narrow pelvic strait through which the fetus must pass; narrow pelvic strait lies between the sacrococcygeal joint, the two ischial spines, and the lower border of the symphysis pubis it's the space b/w the narrow pelvic strait and the anatomical outlet How does the typical female pelvis compare to the male pelvis? Compared to the male pelvis, females have: - a larger pelvic outlet - wider pubic arch - wider, more circular pelvic inlet
- anterior fontanelle (or bregma) is found at the junction of the sagittal, coronal, and frontal sutures; closes by 18 months of age
What is moulding?
- moulding is used to describe the change in shape of the fetal head that takes place during its passage through the birth canal - alteration is possible because the bones of the vault allow a slight degree of bending and the skull bones are able to override the sutures - moulding is a protective mechanism and prevents the fetal brain from being compressed as long as it is not excessive, too rapid or in an unfavourable direction
What is attitude?
- used to describe the degree of flexion or extension of the head on the neck - determines which diameters will present in labour and therefore influences outcome - attitude should be one of flexion smallest diameter will be present labour will be most effective
What is presentation?
Refers to which anatomical part of the fetus is leading, that is, closest to the pelvic inlet of the birth canal.
What is lie?
- the relationship between the long axis of the fetus and the long axis of the uterus/mother - can be longitudinal, oblique, or transverse - majority of cases, lie is longitudinal owing to the ovoid shape of the uterus - oblique refers to when the fetus lies diagonally across the long axis of the uterus - transverse refers to the fetus lying at right angles across the long axis of the uterus
What is station?
- the relationship between the presenting part of the baby -- the head, shoulder, buttocks, or feet -- and two parts of the mother's pelvis called the ischial spines; normally the ischial spines are the narrowest part of the pelvis; they are a natural measuring point for the delivery progress - If the presenting part lies above the ischial spines, the station is reported as a negative number from -1 to -5 (each number is a centimeter) - If the presenting part lies below the ischial spines, the station is reported as a positive number from +1 to +5 - The baby is said to be "engaged" in the pelvis when it is even with the ischial spines at 0 station.
What is position?
- the relationship between the denominator of the presentation and six points on the pelvic brim - anterior positions are more favourable than posterior positions because when the fetal back is at the front of the uterus it conforms to the concavity of the mother's abdominal wall and the fetus can flex more easily - in a vertex presentation: Left occipitoanterior (LOA) Right occipitoanterior (ROA) Left occipitolateral (LOL) Right occipitolateral (ROL) Left occipitoposterior (LOP) Right occipitoposterior (ROP) Direct occipitoanterior (DOA) Direct occipitoposterior (DOP)
What is the widest measurement of the pelvic brim? What does it measure
Transverse: 13 cm
What is the widest measurement of the pelvic cavity? What does it measure Tricksy! All diameters (anteroposterior, oblique, and transverse) measure 12 cm. What is the widest measurement of the pelvic outlet? What does it measure
Anteroposterior: 13 cm
What is the point in the mechanisms of labour when the baby's head rotates to fit through the anteroposterior diameter?
Internal Rotation
Name the six longitudinal diameters and two transverse diameters of the fetal skull and their measurements (in cm). Longitudinal: - sub-occipitobregmatic (SOB) = 9.5cm - sub-occipitofrontal (SOF) = 10cm - occipitofrontal diameter (OF) = 11.5cm - mentovertical (MV) = 13.5cm - sub-mentovertical (SMV) = 11.5cm - sub-mentobregmatic (SMB) = 9.5 cm Transverse: - biparietal = 9.5 cm - bitemporal = 8.2 cm