Contracted Pelvis. Fetal
Macrosomia
Lecture by Andriy Berbets
Measurement of the pelvis
Normal pelvis
Normal pelvis
Anatomically contracted pelvis
• The diagnosis is correct, if at least one
diameter is contracted 2cm +
• Classification:
...
Anatomically contracted pelvis
Classification (by degree of contraction)
- 1st degree (conjugata vera 11-9 cm)
- 2nd degre...
Generally contracted pelvis
Generally contracted pelvis
Generally contracted pelvis
• All the dimensions are equally contracted
(longitudinal and transverse)
• Delivery:
- over-f...
Generally contracted pelvis
Generally contracted pelvis
Generally contracted pelvis
Generally contracted pelvis
Simple flat pelvis
Simple flat pelvis
•
•
•
•

All longitudinal dimensions are contracted
Internal rotation is problematic
Moderate extension...
Asynclitism
Rachitic flat pelvis
Transversely contracted pelvis
Alternative classification
Alternative classification
Michaelis’ rhombus
Clinically contracted pelvis
•
•
•
-

Anatomical dimensions are normal
But fetus is too big and can’t pass through
Conditi...
Clinically contracted pelvis
•
-

Diagnosis:
No fetal head’s descending
Cervix is not closed to fetal head
High standing o...
Vasten’s sign
Threat of uterine rupture
Coxalgic pelvis
Ankilotic oblique-deformated pelvis
Pelvis due to osteomalatia
Scoliotic pelvis
Pelvis with no symphysis
Pelvis with no symphysis (“cleft”)
Osteoma
Shoulder dystocia
Shoulder dystocia
Thank you!
Upcoming SlideShare
Loading in...5
×

Contracted pelvis

1,729

Published on

Contracted pelvis in Obstetrics

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
1,729
On Slideshare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
75
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Transcript of "Contracted pelvis"

  1. 1. Contracted Pelvis. Fetal Macrosomia Lecture by Andriy Berbets
  2. 2. Measurement of the pelvis
  3. 3. Normal pelvis
  4. 4. Normal pelvis
  5. 5. Anatomically contracted pelvis • The diagnosis is correct, if at least one diameter is contracted 2cm + • Classification: - Generally contracted pelvis - Simple flat pelvis - Flat rachitic pelvis - Transversely contracted pelvis
  6. 6. Anatomically contracted pelvis Classification (by degree of contraction) - 1st degree (conjugata vera 11-9 cm) - 2nd degree (conjugata vera 9-7,5 cm) - 3rd degree (conjugata vera 7,5-6,5 cm) - 4th degree (conjugata vera less than 6,5 cm)
  7. 7. Generally contracted pelvis
  8. 8. Generally contracted pelvis
  9. 9. Generally contracted pelvis • All the dimensions are equally contracted (longitudinal and transverse) • Delivery: - over-flexion of the fetal head, - passing of the fetal head through the pelvis on oblique dimension, - fetal head can’t fixate good enough to pubic symphysis
  10. 10. Generally contracted pelvis
  11. 11. Generally contracted pelvis
  12. 12. Generally contracted pelvis
  13. 13. Generally contracted pelvis
  14. 14. Simple flat pelvis
  15. 15. Simple flat pelvis • • • • All longitudinal dimensions are contracted Internal rotation is problematic Moderate extension of fetal head Asynclitism
  16. 16. Asynclitism
  17. 17. Rachitic flat pelvis
  18. 18. Transversely contracted pelvis
  19. 19. Alternative classification
  20. 20. Alternative classification
  21. 21. Michaelis’ rhombus
  22. 22. Clinically contracted pelvis • • • - Anatomical dimensions are normal But fetus is too big and can’t pass through Conditions for diagnosis: Good regular uterine contractions Cervical dilation 8cm + Absence of amniotic sac Empty urine bladder
  23. 23. Clinically contracted pelvis • - Diagnosis: No fetal head’s descending Cervix is not closed to fetal head High standing of contraction ring Early pushing efforts (head is not in pelvic cavity) Edema of cervix, vagina and vulva Symptoms of urine bladder’s pressure Positive signs of Vasten and Tsangemeister
  24. 24. Vasten’s sign
  25. 25. Threat of uterine rupture
  26. 26. Coxalgic pelvis
  27. 27. Ankilotic oblique-deformated pelvis
  28. 28. Pelvis due to osteomalatia
  29. 29. Scoliotic pelvis
  30. 30. Pelvis with no symphysis
  31. 31. Pelvis with no symphysis (“cleft”)
  32. 32. Osteoma
  33. 33. Shoulder dystocia
  34. 34. Shoulder dystocia
  35. 35. Thank you!
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×