THE PELVIMETRY

Pelvimetry is briefly an evaluation of the bone structures in the female pelvis for normal delivery.
The pelvis consists of the joining of various bones and includes three important openings in the form of pelvic intervention, middle pelvic, pelvic outlet. Also in women, the pelvis is structurally 4 types (Coldwell-Moloy classification): Gynecoid pelvis, android pelvis, andropoid pelvis, platipelloid pelvis.
- The pelvic intervention in the gynecoid pelvis is oval and women with this pelvis structure are the luckiest group in terms of normal vaginal delivery. Spina scots are faint.
- Platipelloid pelvis is flat. The anterior-posterior diameter of the pelvis is shorter than the transverse diameter. This is the most inappropriate pelvis for normal delivery. Transverse posture can be seen in the deep.
- In the Android pelvis type, the pelvic intervention is heart-shaped, also called the male-type pelvis structure. Spina scripts are evident.
- In the andropoid pelvis type, the anterior-posterior diameter of the pelvis is longer than the transverse diameter. A straight posture can be seen at height.
Pelvimetry can be evaluated by hand examination and radiological imaging methods, computed tomography, MR, ultrasonography. In addition, tools called "pelvimeter" produced for this purpose have been used extensively in the past years.
Clinical pelvimetry
- Clinical pelvimetry is the evaluation of some lengths and angles in the pelvis structure by hand examination. Structures evaluated in clinical pelvimetry:
- Conjugara diagonalis: It is the distance from the bottom of the pubis bone to the sacral promontory, the middle finger and index finger are extended along this plane and the distance is measured. Conjugata diagonalis should not be less than 11.5 cm.
- Sacral concavity
- Spina ischiadica's distinction and distance between them
- Pubis six angles
- Sacrococcygeal joint
Measurements using pelvimeter (External pelvimetry):
With the help of tools called pelvimeter, the size of the pelvis is evaluated from the outside and interpreted.
External conjugate measurement, interspinal distance, intercrystalline distance measurements are made.
X-ray pelvimetry
It is the visualization of the pelvis bones by x-ray rays by direct radiography. Here, the distance and angles between the bones are evaluated. Its use has been widely discontinued after the 1960s and 70s due to the risk of the fetus being damaged by x-rays. Some of the studies have shown that it is not successful in predicting the mode of delivery or the presence of CPD.
Ultrasonographic pelvimetry
In this method, it is an advantage that x-ray rays are not used and the application is easy. Ultrasonography can be performed abdominally, transvaginally or transperineally. The diameter of the head of the fetus and the distance between the pelvic bones are compared.
MR Pelvimetry
The advantage of MRI is that both bone and soft tissues related to mother and baby can be examined. It also does not contain ionizing radiation.
In a study, it was stated that MRI pelvimetry is useful in predicting dystocia.
ADDITIONAL INFORMATION:
- The narrowest part of the pelvis is also the narrowest part of the middle pelvis is the interspinous distance (spina ischial distance). It is about 10 cm.
- The narrowest diameter of the pelvic intervention is conjugata vera obstetric. The symphysis is the distance between the inner face of the pubis and the promontorium.
- The diameter measured by hand examination in the pelvic intervention is conjugata vera diagolanis, the diameter extending from the lower edge of the symphysis pubis to the promontorium.
- The distance between the promontorium and the upper edge of the symphysis pubis is called conjugata vera anatomika.
- The smallest of the fetal head diameters is the bitemporal diameter (transverse diameter).
- The largest diameter of the fetal head is the occipitomental diameter. It is the distance between the occiput and the tip of the chin.
- The periphery of the fetal head that passes through the suboxiptobregmatic diameter is the smallest circumference. This diameter is very important for normal delivery.


Facebook Comments

Subscribe to: Post Comments (Atom)

Popular Posts