Contracted pelvis

Description about contracted pelvis, rachitic pelvis, osteomalacic pelvis, causes and its management.

1. CONTRACTED PELVIS B y R . V i j a y a l a k s h m i I I I r d B H M S

2. DEFINITION IT IS A PELVIS IN WHICH ONE OR MORE OF ITS DIAMETER IS REDUCED BY MORE THAN 1cm .

3. ETIOLOGY NUTRITIONAL DEFECTS RACHITIC FLAT PELVIS OSTEOMALACIC PELVIS

4. RACHITIC FLAT PELVIS INLET: SACRAL PROMONTORY IS PUSHED DOWNWARDS. ANTROPOSTERIOR DIAMETER: SHORT SACRUM: FLAT & TILTED BACK SACROCOCCYGEAL JOINT: SHARP ANGULATION

5. OSTEOMALACIC PELVIS DUE TO SOFTENING OF PELVIC BONES. INLET : TRIRADIATE SACRUM : SHORT COCCYX: PUSHED FORWARD

6. DISEASES TUMORS TUBERCULAR ARTHRITIS

7. TUMOR OF HIP

8. TUBERCULOSIS OF HIP

9. INJURIES FRACTURES KYPHOSIS SCOLIOSIS SPONDYLOLISTHESIS

10. FRACTURES OF PELVIS

11. SPINAL DEFORMITIES

12. KYPHOTIC PELVIS : SACRUM UPPER PART: TILTED BACKWARD LOWER PART: NARROW & STRAIGHT ANTROPOSTERIOR DIAMETER: INCREASED AT INLET DECREASED AT OUTLET

13. SCOLIOSIS ACETABULAM: PUSHED INWARDS ON WEIGHT BEARING SIDE. ONE OF THE OBLIQUE DIAMETER CONTRACTED.

14. SPONDYLOLISTHESIS

15. DEVELOPMENTAL DEFECTS NAEGELE’S PELVIS ROBERT’S PELVIS HIGH / LOW ASSIMILATION PELVIS.

16. NAEGELE’S PELVIS

17. NAEGELE’S PELVIS DUE TO ARRESTED DEVELOPMENT OF ONE ALA OF SACRUM. PELVIS IS CONTRACTED AT ALL LEVELS & MORE MARKED IN OUTLET . ILIO PECTINEAL LINE: STRAIGHT ON AFFECTED SIDE.

18. NAEGELE’S PELVIS

19. ROBERT’S PELVIS ALA OF BOTH SIDES ARE ABSENT . SACRUM: FUSED WITH INNOMINATE BONES .

20. ROBERT’S PELVIS

21. ASYMMETRICAL PELVIS

22. DIAGNOSIS IS BASED ON: PAST HISTORY TRAUMA PHYSICAL EXAMINATION PELVIC BONE DEFORMITY ABDOMINAL EXAMINATION

23. INVESTIGATIONS: PELVIMETRY IS USED IN ASSESSMENT OF THE DIMENSIONS & CAPACITY OF ADULT FEMALE PELVIS IN RELATION TO BIRTH OF THE BABY .

24. OTHER INVESTIGATIONS: CT PELVIS MRI USG

25. EFFECTS OF CONTRACTED PELVIS 1.PREGNANCY INCARCERATION OF RETROVERTED GRAVID UTERUS . MALPRESENTATIONS.

26. Contd... 2.LABOUR EARLY RUPTURE OF MEMBRANES. CORD PROLAPSE SLOW CERVICAL DILATATION PPH SHOCK

27. MECHANISM OF LABOUR IN CONTRACTED PELVIS

28. THE DIFFERENCE IN MECHANISM OF LABOUR IN CONTRACTED PELVIS FROM NORMAL PELVIS IS THAT: THE HEAD REMAINS DEFLEXED & THE ENGAGEMENT IS DELAYED. ONCE THE HEAD NEGOTIATES THE BRIM THERE IS NO DIFFICULTY IN THE CAVITY & OUTLET. THEN THE NORMAL MECHANISM OF LABOUR FOLLOWS.

29. MANAGEMENT OF CONTRACTED PELVIS IN MINOR DEGREE VAGINAL DELIVERY AT TERM . IN MODERATE / SEVERE INDUCTION OF LABOUR. ELECTIVE CS AT TERM.

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