PROBLEMS OF THE PASSAGEWAY Flashcards
causes of alterations in the conformation of the pelvis:
- poor n___
- e___
- r___ factors
- d___
- m___ factors
nutrition
environment
racial
disease
mechanical
inlet - heart shape, funnel shape
android
midpelvis -
Midpelvic diameters reduced
Sacrosciatic notch narrow
symphysis is long
palvic cavity deep
android
outlet -
narrow suprapubic angle
lateral walls tend to converge
short transverse diameter of the outlet
android
most common pelvic cause of difficult labor
Not favorable for vaginal birth
Descent into pelvis is slow
android
in android pelvis, the fetal head enters in what position
transverse or posterior
inlet
- short AP & wide TD
- shape of inlet, is a narrow transverse ellipse, with the widest diameter about equidistant from the symphysis pubis & promontory
- short AP diameters, both AP relatively shallow
platypelloid
midpelvis- capacity is reduced
patypelloid
outlet - capacity may be inadequate
platypelloid
Not favorable for vaginal birth
Fetal head engages in transverse position in marked asynclitism
platypelloid
inlet
- AP diameter of the inlet is long, whereas the transverse is relatively or absolutely shortened
- shape of the superior aperture is that of a longitudinal ellipse
anthropoid
midpelvis
- widest TD is considerably in front of the promontory, the posterior segment is deep
- sacrosciatic notch is wide, sacrum is more or less vertical & often contains six segments
anthropoid
outlet - reduce capacity
anthropoid
Not favorable for vaginal birth
head enters the pelvis obliquely & is posterior more frequently than anterior
anthropoid
what is usually persistent in delivery with an anthropoid pelvis
occipito-posterior
A contracture (narrowed diameter) in any of the described areas can result in ___ if fetus is larger than the pelvic diameters
cephalopelvic disproportion - CPD
criteria for CPD
diagonal <11.5 cm
AP < 10 cm
TD < 12 cm
outlet < 8 cm
in CPD - hypotonic or hypertonic?
hypotonic
true or false - in CPD there is uncontrollable pushing prior to complete dilation
true
in CPD, there is ___ of the anterior portion of cervix (lip)
edema
pelvic inlet is ___ if the shortest AP is <10cm or the greatest TD is <12cm
contracted
- generally ___ is the most common type of pelvic deformity
- usually found in small-boned, undersized women
- android & platypelloid types are predisposed to CPD
contracted pelvis
Inter-ischial tuberous diameter of <8 cm constitutes ___
outlet contracture
true or false - Outlet & midpelvic contractures frequently occur simultaneously
true
applied to contraction of plane of least dimensions, & implies that either the TD or AP diameter, or both, are reduced in size
mid-pelvic or mid-plane contraction
___ contraction is associated with anthropoid, while ___ contraction with the platypelloid
transverse
AP
may result from narrowness of the upper part of the sacrosciatic notch, from a straight sacrum, or from one that is inclined forward
transverse contraction
maternal implications of CPD
- prolonged labor
- membrane rupture
- uterine rupture
- necrosis of soft tissues
- difficult forceps assisted birth = damage to soft tissue
fetal neonatal implication of CPD
- cord prolapse
- excessive molding of head
- traumatic, forceps-assisted birth = damaged skull and CNS
