Android pelvis

THIS SLIDE CONTAINS these are points about android pelvis
Introduction
Aetiology
Diagnosis
Mechanism of labour
Management
complication

1. Android pelvis PRESANTER: DR Arshwi MODERATOR: DR SAUMYA

2. Introduction Aetiology Diagnosis Mechanism of labour Management complication

3. This type of pelvis is in tall women with narrow hips and in African women. heart-shaped brim and is quite narrow in front. In this pelvis babies lie with their back against their mothers’ back and may experience longer labour

4. women take an active role during their labour and need to squat and move around as much as possible.

5. INLET Shape: triangular Ant. & post. Segment: narrow/ short Sacrum: SA <90⁰ inclined forward & straight CAVITY Narrow & deep sacrosciatic joint Convergent : side walls OUTLET Prominent : ischial spines Long and straight : pubic arch Narrow: subpubic angle Short: bituberous diameter FEATURES

6. INLET Position : OL/ oblique OP Transverse /oblique diameter of engagement with delayed & difficult engagement CAVITY Internal rotation :difficult ant rotation Doesnt occurs early above ischial spine,chance of arrest OULET Delivery: difficult with increase chance of perineal injuy OBSTETRIC OUTCOME

7. HISTORY Bad obstetric history- prolonged labour leads to: *difficult forceps *CS *Still birth *Early neonatal death *Late neurological symptoms Evidence of maternal injuries(complete perineal tear) PHYSICAL EXAMINATION: Tall stature DIAGNOSIS

8. * Dystocia dystrophia syndrome: Short , Stockily built, Bull neck, Broad shoulders Short thigh ,Obese, Male distribution of hairs Delayed menarche Sub fertile having dys -menorrhea / oligo -menorrhea /irregular periods Increase incidence of pre- eclampsia,tendency of postmaturity ,android type of pelvis *OP position is common *During labor inertia is common

9. *tendency of deep transverse arrest or outlet dystocia .... *Chance of lactation failure ABDOMINAL EXAMINATION: Inspection : pendulous abdomen in primi Obstetrical : may be malpresentation in primigravidae non engagement of head :in last 3 to 4 weeks in primigravidae Pelvimetry : bimanual /radio- pelvimetry /CT/MRI

10. Timing: Procedure : Empty the bladder, Position: Aseptic precautions Features to be noted : Cervix , Station ,Engagement if not then CPD Elasticity of perineal muscle Steps : CLINICAL PELVIMETRY

11. X-RAY CT.. MRI

12. Depending on severity MANAGEMENT OF CPD

13. Metarnal : During pregnancy Mal presentation Pendulous abdomen Non engagement Pylonephritis .... COMPLICATON

14. During labour inertia , slow cervical dilatation & prolong labour Premature rupture of membrane & cord prolapse Obstructed labour & rupture uterus Necrotic genito urinary fistula Injury to pelvic joints & nerves from difficult forceps delivery PPH

15. Fetal : IC haemorrhage Asphyxia Nerve injury Fracture of skull Intra amniotic infection

16. D C DUTTA’S textbook of obstetrics 7th edition Source for pictures : internet REFERENCE

17. THANK YOU