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Y4R2 - Obstetrics I 🤰 > L8: Contracted Pelvis & Cephalopelvic Disproportion > Flashcards

L8: Contracted Pelvis & Cephalopelvic Disproportion Flashcards

1
Q

Read Dystocia

Def of Contracted Pelvis

A
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2
Q

Def of Cephalopelvic or fetopelvic disproportion

A

Disproportion () head & pelvis (in cephalic presentation) or () fetus & pelvis (in presentations other than cephalic)

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3
Q

Compare between CP & CPD

A
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4
Q

Factors affecting size & shape of pelvis

A
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5
Q

Classification of contracted pelvis

A
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6
Q

Etiology of Contracted Pelvis

A
  • Causes in Pelvis
  • Causes in Spine
  • Causes in LLs
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7
Q

Contracted Pelvis

  • Causes of Pelvis
A
  • Congenital
  • Metabolic
  • Trauma
  • Tumor
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8
Q

Pelvic Causes of Contracted Pelvis

  • Congenital
A
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9
Q

Naegele’s Pelvis

A

Absence of 1 ala of sacrum (obliquely CP or asymmetric pelvis).

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10
Q

Robert’s Pelvis

A

Absence of 2 alae of sacrum (transversely (PI)

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11
Q

High assimilation Pelvis

A

Sacrum is made of 6 fused segments.

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12
Q

Low assimilation Pelvis

A

Sacrum is made of 4 fused segments.

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13
Q

Split Pelvis

A

Absent pubic bone usually associated e ectopia vesica)

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14
Q

Pelvic Causes of Contracted Pelvis

  • Metabolic Causes
A
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15
Q

Pelvic Causes of Contracted Pelvis

  • Trauma
A

Fractures

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16
Q

Pelvic Causes of Contracted Pelvis

  • Tumor
A

osteoma, …..

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17
Q

Causes of Contracted Pelvis

  • Spine Causes
A
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18
Q

Causes of Contracted Pelvis

  • LLs Causes
A
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19
Q

Etiology of CPD

A
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20
Q

Complications of CP & CPD

A
  • Maternal
  • Fetal
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21
Q

Complications of CP & CPD

  • Maternal
A
  • During pregnancy
  • During Labor
  • During Puerperium
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22
Q

Complications of CP & CPD

  • Maternal (During Pregnancy)
A
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23
Q

Complications of CP & CPD

  • Maternal (During Labor)
A
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24
Q

Complications of CP & CPD

  • Maternal (During Puerperium)
A

PPH & puerperal sepsis.

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25
Q

Complications of CP & CPD

  • Fetal & Neonatal
A
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26
Q

Dx of CP & CPD

A

(history -Ex - Pelvimetry - Cephalometry - CPD Tests)

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27
Q

Dx of CP & CPD

  • Hx
A
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28
Q

Dx of CP & CPD

  • General Ex
29
Q

Dx of CP & CPD

  • Abdominal Ex
30
Q

Dx of CP & CPD

  • Pelvimetry
31
Q

Pelvimetry of CP & CPD

  • Indications
A

Done for all primigravidas in last weeks of pregnancy & multiparas e bad obstetric history.

32
Q

Pelvimetry of CP & CPD

  • Time of Clinical Pelvimetry
A

Done at 36 wk through vaginal examination by Rt hand e patient in lithotomy position eout anesthesia

33
Q

Pelvimetry of CP & CPD

  • Method of Clinical Pelvimetry
A
  • Internal & External
34
Q

Pelvimetry of CP & CPD

  • Internal Clinical Pelvimetry
35
Q

Pelvimetry of CP & CPD

  • External Clinical Pelvimetry
36
Q

Sacral promontory

A

Normally, not easily palpable.

37
Q

Diagonal conjugate diameter

A

Normally =12.5 cm.

38
Q

Sacrum

A
  • For width, curve & any anomaly (normally it is broad & concave from above downwards & from side to side).
39
Q

Side walls of pelvis

A

To determine whether they are straight, divergent or convergent.

40
Q

Ischial spines

A

To determine whether they are prominent or not &
measure distance ( ) them (normally = 10 cm)

41
Q

Sacrospinous ligament

A

Normally = 2 fingers breadth (3.5 cm)

42
Q

Width of sacrosciatic notch

A

Normally accommodates 2 fingers.

43
Q

Mobility of coccyx

A

Normally, it is mobile) & can recede backwards easily.

44
Q

AP diameter of outlet

A

Measured by the same manner as diagonal conjugate but tip of middle finger touches tip of sacrum,

45
Q

Capacity of subpubic angle

A

Normally, angle can accommodate 2 (fingers near apex eout any difficulty

46
Q

External Pelvimetry

  • Inlet pelvimetry
A

Measure diameters of false pelvis by Martin’s pelvimeter (has little importance).

47
Q

External Pelvimetry

  • Outlet Pelvimetry
48
Q

Radiological Pelviemtry

49
Q

Cephalometry

50
Q

Time of CPD Tests

A

After 36 weeks if head isn’t engaged especially in primigravidas).

51
Q

Idea of CPD Tests

A
  • Fetal head is used as a pelvimeter (fetal head is the best pelvimeter for inlet).
52
Q

Methods of CPD Tests

53
Q

Methods of CPD Tests

  • Pinard Maneuver (External Method)
54
Q

Methods of CPD Tests

  • Muller-Kerr’s Maneuver (External & Internal Method)

“More accurate”

55
Q

Disadvantages of CPD Tests

56
Q

Results of CPD Tests

57
Q

Results of CPD Tests

  • No disproportion
A

Head can be made to enter pelvis

58
Q

Results of CPD Tests

  • Disproportion
59
Q

Def of Pelvic Inlet Contraction

60
Q

Degrees of Pelvic Inlet Contraction

61
Q

Effects of Pelvic Inlet Contraction

62
Q

Clinical Dx of Pelvic Inlet Contraction

63
Q

Management of Pelvic Inlet Contraction

64
Q

Def of Trial Labor

65
Q

Patient Selection for Trial Labor

66
Q

Prerequisities in Trial Labor

67
Q

Technique of Trial Labor

68
Q

Manifestations of Progress in Trial Labor

(Good Omens)

69
Q

Termination (Results) of Trial Labor

Y4R2 - Obstetrics I 🤰 (59 decks)

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