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NCMN 109A - Maternal Lecture > Passageway > Flashcards

Passageway Flashcards

1
Q

Types of Pelvis

A

Gynecoid
Android
Anthropoid
Platypelloid

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2
Q

“Female” pelvis

A

Gynecoid

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3
Q

Ideal for childbeanring

A

Gynecoid

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4
Q

Wellrounded anteror, lateral and posterior segments

A

Gynecoid

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5
Q

“Male” pelvis

A

Android

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6
Q

Heavy, heart-shaped pelvis, increased incidence of posterior fetal position

A

Android

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7
Q

Increased incidence of forceps deliver

A

Android

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8
Q

Contracted midplane and outlet increase cesarean delivery

A

Android

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9
Q

Oval shape, with anteroposterior(AP) diameter greater than the transverse

A

Anthropoid

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10
Q

Wel-rounded posterior and oval inlet

A

Anthropoid

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11
Q

Anterior segment narrower than postenior

A

Anthropoid

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12
Q

Favors posterior fetal position, but adequate for vaginal delivery

A

Anthropoid

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13
Q

Not conducive to vaginal delivery

A

Platypelloid

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14
Q

Flattened gynecoid-type pelvis

A

Platypelloid

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15
Q

Wide transverse diameter and short AP diameter

A

Platypelloid

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16
Q

Widest of all pelvic types

A

Platypelloid

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17
Q

Pelvic Inlet

Anteroposterior:
Oblique:
Transverse:

A

11; 12; 13

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18
Q

Pelvic Cavity

Anteroposterior:
Oblique:
Transverse:

A

12; 12; 12

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19
Q

Pelvic Outlet

Anteroposterior:
Oblique:
Transverse:

A

13; 12; 11

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20
Q

is a pregnancy complication in which there is a size mismatch between the mother’s pelvis and the head of the baby

A

Cephalopelvic Disproportion

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21
Q

disparity between the fetal head and the maternal pelvis

A

Cephalopelvic Disproportion

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22
Q

the presenting part of the fetus (usually the head) is too large to pass through the woman’s pelvis.

A

Cephalopelvic Disproportion

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23
Q

Cephalopelvic disproportion cannot be diagnosed before the ________ week of pregnancy because before then the fetal head is too small for comparison with the pelvis but at _____ week the fetus would have reached its maximum size.

A

36th; 36th

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24
Q

It is a pelvis in which one or more of its diameters is reduced below the normal by one or more centimeters.

A

CONTRACTED PELVIS

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25
It is a pelvis in which its size & shape is sufficiently abnormal that interfere with vaginal delivery of normal size fetus
CONTRACTED PELVIS
26
Factors affecting the size and shape of pelvis
- Developmental factor: hereditary or congenital. - Racial factor. : Small mother(Thai), African descent - Nutritional factor: malnutrition results in small pelvis. - Sexual factor: as excessive androgen may produce android pelvis. - Metabolic factor: as rickets and osteomalacia. - Trauma, diseases or tumours of the bony pelvis, legs or spines.
27
Cephalopelvic Disproportion (CPD) Maternal Causes:
- Contracted Pelvis e.g. Deformed through Rickets - Pelvic tumour - Stenosis or scarring of cervix - Vaginal stenosis
28
Cephalopelvic Disproportion (CPD) Fetal Causes:
Malposition Malpresentation Hydrocephaly Macrosomia
29
Cephalopelvic Disproportion (CPD) MACROSMIA due to:
Hereditary factors Diabetes Postmaturity Multiparity
30
ETIOLOGY OF CONTRACTED PELVIS A. Causes: DEVELOPMENTAL (congenital):
1. Small gynaecoid pelvis (generally contracted pelvis). 2. Small android pelvis. 3. Small anthropoid pelvis 4. Small platypelloid pelvis (simple flat pelvis) 5. Naegele’s pelvis: absence of one sacral alae 6. Robert’s pelvis: absence of both sacral alae. 7. High-assimilation pelvis: The sacrum is composed of 6 vertebrae. 8. Low assimilation pelvis: The sacrum is composed of 4 vertebrae. 9. Split pelvis: splitted symphysis pubis
31
The sacrum is composed of 6 vertebrae
High-assimilation pelvis
32
The sacrum is composed of 4 vertebrae.
Low assimilation pelvis
33
splitted symphysis pubis
Split pelvis
34
ETIOLOGY OF CONTRACTED PELVIS B. Causes: METABOLIC
1. Rickets 2. Osteomalacia (triradiate pelvic brim)
35
ETIOLOGY OF CONTRACTED PELVIS
Developmental Metabolic Traumatic: as fractures Neoplastic: as osteoma Infection : TB Spine Lower Limbs
36
ETIOLOGY OF CONTRACTED PELVIS F. Causes: SPINE
1. Lumbarkyphosis 2. Lumbar scoliosis 3. Spondylolisthesis
37
ETIOLOGY OF CONTRACTED PELVIS G. Causes: LOWER LIMBS
1. Dislocation of one or both femurs. 2. Atrophy of one or both lower limbs. 3. Oblique or asymmetric pelvis: one oblique diameter is obviously shorter than the other. This can be found in: Diseases, fracture or tumors affecting one side.
38
General Examination for Contracted Pelvis
Gait Height Spines and lower limbs Manifestation of Rickets Dystocia dystrophia syndrome Abdominal examination
39
women with _________________ height usually have contracted pelvis.
less than 150 cm
40
Manifestations of rickets as:
- square head - rosary beads in the coastal ridges. - pigeon chest - Harrison’s sulcus and bow legs.
41
- the woman is *short, obese stocky, subfertile, - has android pelvis
Dystocia dystrophia syndrome
42
Abdominal examination:
- Nonengagement of the head: in the last 3-4 weeks in primigravida - Pendulous abdomen: in a primigravida. - Malpresentations: are more common.
43
is the narrowing of the anteroposterior diameter to less than 11 cm or the transverse diameter to 12 cm or less.
Inlet contraction
44
cause of Inlet Contraction
rickets in early life or by an inherited small pelvis
45
If the fetal head engages during the ___________ week of pregnancy, then the pelvic inlet is adequate.
36th to 38th
46
Every primigravida should have _______________ taken and recorded _________________ of pregnancy so that a birth decision can be made.
pelvic measurements; before week 24
47
Outlet contraction is the narrowing of the transverse diameter at the outlet to less than 11 cm.
Outlet contraction
48
It is assessment of the pelvic diameters and capacity done at 38-39 weeks
PELVIMETRY
49
Pelvimetry is assessment of the pelvic diameters and capacity done at ___________
38-39 weeks
50
Internal pelvimetry for
inlet, cavity, and outlet.
51
External pelvimetry for
inlet and outlet
52
IMAGING pelvimetry:
-X-RAY -CT SCAN (COMPUTED TOMOGRAPHY) -MRI (Magnetic resonance imaging
53
Internal Pelvimetry is done through
vaginal examination
54
If there is no engagement in primigravidas, then either a _______________________________ should be suspected.
fetal abnormality or a pelvic abnormality
55
If the membranes rupture, then the risk of ____________________________ increases greatly
cord prolapse
56
Try to palpate the ____________________- to measure the diagonal conjugate.
sacral promontory
57
a ring-shaped bone separating the false pelvis from the true pelvis
pelvic brim
58
It is where the engagement of the fetal head takes place
pelvic brim
59
pelvic brim is approximate __ cm
36 cm
60
can be used for externalpelvimetry
Thom’s, Jarcho’s or crossing pelvimeter
61
betweenthe anterior superior iliac spines.
Interspinous diameter (25cm)
62
between the most far points on the outer borders of the iliac crests.
Intercrestal diameter (28 cm)
63
Ultrasonography can detect
the biparietal diameter (BPD), the occipito-frontal diameter, and the circumference of the head.
64
is difficult to interpret
Radiology (X-ray)
65
Done to detect inlet if the head is not engaged in the last 3-4 weeks in a primigravida
CPD TESTS
66
It is more valuable in detection of the degree of disproportion.
Muller-Kerr’s method
67
The patient evacuates her bladder and rectum.
Muller-Kerr’s method
68
In Muller-Kerr’s method, the patient is placed in the ____________________
dorsal position
69
The anterior surface of the head is in line with the posterior surface of the symphysis
Minor disproportion
70
The anterior surface of the head is in line with the anterior surface of the symphysis.
Moderate disproportion (1st degree disproportion)
71
The head overrides the anterior surface of the symphysis.
Marked disproportion (2nd degree disproportion)
72
The true conjugate is 9-10 cm. Itcorresponds to minor disproportion, spontaneous delivery is possible.
Minor degree
73
The true conjugate is 8-9 cm. It corresponds to moderate disproportion. Can delivery vaginally but complication may arise.
Moderate degree
74
The true conjugate is 6-8 cm. Itcorresponds to marked disproportion, CS is indicated.
Marked degree

NCMN 109A - Maternal Lecture (9 decks)

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