PELVIC ASSESSMENT

DEFINITION A pelvic assessment is a clinical assessment of the size and shape of the mothers pelvis by means of a vaginal examination.

TYPES

Types of pelvis 1.True pelvis 2.False pelvis

True pelvis

SIDE VIEW

Land marks

PLANES

OBSTETRIC CONJUGATE

BIMANNUAL PELVIC ASSESSMENT

WHO CAN PERFORM IT

Where can it be performed?

Conts……

Articles Required

Initial steps…..

FEATURES 1.State of the cervix 2.To note the station of the presenting part in relation to ischial spines. 3.To test the CPD in the non engaged head. 4.To note the resilience and elasticity of the perineal muscles.

Sacrum It is smooth, well curved & usually inaccessible beyond the 3 pieces.

Diagonal conjugate

Sacro-sciatic notch The configuration of the notch denotes the capacity of the posterior segment of the pelvis and the side walls of the lower pelvis.

Ischial Spines They may be prominent & encroach to the cavity there by diminishing the available space in the mid pelvis.

Posterior surface of the symphysis pubis It normally forms a smooth rounded curve. Presence of angulation or beaking indicates abnormality.

Pubic angle A.In narrow angle, it roughly corresponds to fully abducted middle & index fingers. B. The inferior pubic rami are defined, the angle roughly corresponds to the fully abducted thumb and index fingers.

Transverse diameter of the outlet It is measured by placing the knuckles of the first inter phalangeal joints or knuckles of the clinched fist between the ischial tuberosities.

Sidewalls Normally they are not easily palpable by sweeping the fingers unless convergent.

Pelvic X-Rays…..

NURSES ROLE