the main
about the project
Medicine news
To the authors
Licensed books on medicine
<< Ahead Next >>

Measurement of pelvis size in pregnant women

The study of the pelvis is important in obstetrics because its structure and size have a decisive influence on the course and outcome of labor. Normal pelvis is one of the main conditions for the correct course of labor. Deviations in the structure of the pelvis, especially the reduction of its size, impede the course of labor or represent insurmountable obstacles for them. The study of the pelvis produced by inspection, palpation and measurement of its size. On examination, attention is paid to the entire pelvic region, but the lumbosacral rhombus (Michaelis rhombus) is of particular importance. The Michaelis rhombus is called the shape of the sacrum, which has the contours of the rhomboid area. The upper corner of the rhombus corresponds to the spinous process of the V lumbar vertebra, the lower corner corresponds to the top of the sacrum (the place of discharge of the gluteus maximus muscles), the lateral angles to the upper-posterior ileal bones. Based on the shape and size of the rhombus, it is possible to assess the structure of the bone pelvis, to detect its narrowing or deformation, which is of great importance in the management of labor. In a normal pelvis, the rhombus corresponds to the shape of a square. Its dimensions: the horizontal diagonal of the rhombus is 10-11 cm, the vertical diagonal is 11 cm. With various pelvic constrictions, the horizontal and vertical diagonals will be of different sizes, as a result of which the shape of the rhombus will be changed.

In an external obstetric study, measurements are made with a centimeter tape (circumference of the wrist joint, the size of the Michaelis rhombus, the abdominal circumference and the height of the uterus bottom above the lap) and the obstetric compass (tazomer) to determine the size of the pelvis and its shape.

A centimeter tape measures the largest abdominal circumference at the level of the navel (at the end of pregnancy it is 90-100 cm) and the height of the uterus floor is the distance between the upper edge of the pubic symphysis and the bottom of the uterus. At the end of pregnancy, the height of the uterus floor is 32-34 cm. Measuring the abdomen and the height of the uterus floor above the womb allows the obstetrician to determine the duration of pregnancy, the estimated weight of the fetus, to identify violations of fat metabolism, polyhydramnios, and multiple births. According to the external dimensions of the large pelvis, one can judge the size and shape of the small pelvis. Measurement of the pelvis produced a tazomerom. Only some dimensions (pelvic outlet and additional measurements) can be made with a measuring tape. Usually four sizes of the pelvis are measured - three transverse and one straight. The patient is in the supine position, the obstetrician is sitting on the side of her and facing her. Distantia spinarum - the distance between the most distant points of the anteroposterior iliac bones (spina iliaca anterior superior) - is 25-26 cm. Distantia cristarum - the distance between the most distant points of the iliac crest (crista ossis ilei) is 28-29 cm. Distantia trochanterica - the distance between the greater trochanter of the femur (trochanter major) is 31–32 cm. Conjugata externa (external conjugate) - the distance between the spinous process of the V lumbar vertebra and the upper edge of the pubic symphysis is equal to 20-21 cm. The patient turns to measure the external conjugates on the side, the underlying leg flexes in the hip and knee joints, and the overlying leg pulls out. The button of the tazomer is placed between the spinous process of the V lumbar and I sacral vertebra (supracarpal fossa) in the back and in the middle of the upper edge of the pubic symphysis in front. The size of the outer conjugate can be judged on the size of the true conjugates.
The difference between the outer and the true conjugate depends on the thickness of the sacrum, the symphysis and the soft tissues. The thickness of bones and soft tissues in women is different, so the difference between the size of the outer and true conjugate does not always exactly correspond to 9 cm. To measure the thickness of the bones, use the measurement of the circumference of the wrist joint and the Solovyov index (1/10 of the circumference of the wrist joint). Thin bones are considered thin if the circumference of the wrist joint is up to 14 cm and thick, if the circumference of the wrist joint is more than 14 cm. Depending on the thickness of the bones with the same external dimensions of the pelvis, its internal dimensions may be different. For example, with an outer conjugate of 20 cm and a Solovyov circumference of 12 cm (Solovyov’s index is 1.2), you must subtract 8 cm from 20 cm and get the true conjugate value of 12 cm. With a Solovyov circumference of 14 cm, you must subtract 20 cm from 20 cm at 16 cm, subtract 10 cm, the true conjugate will be 9 and 10 cm respectively. The true size of the conjugates can be judged by the vertical size of the sacral rhombus and the size of the Frank. The true conjugate can be more accurately determined by the diagonal conjugate. The diagonal conjugate (conjugata diagonalis) is the distance from the lower edge of the symphysis to the most prominent point of the cape (13 cm). Diagonal conjugate is determined by vaginal examination of a woman, which is produced with one hand. The direct size of the pelvic outlet is the distance between the middle of the lower edge of the pubic symphysis and the tip of the coccyx. During the examination, the pregnant woman lies on her back with her legs divorced and half bent at the hip and knee joints. The measurement is carried out with a tazomer. This size, equal to 11 cm, is 1.5 cm larger than the true one due to the thickness of the soft tissues. Therefore, it is necessary to subtract 1.5 cm from the resulting figure of 11 cm, we obtain the direct size of the exit from the pelvic cavity, which is equal to 9.5 cm. The transverse size of the output of the pelvis is the distance between the inner surfaces of the ischial tubercles. The measurement is carried out with a special tazomer or a measuring tape, which is applied not directly to the ischial tubercles, but to the tissues covering them; therefore, it is necessary to add 1.5-2 cm (thickness of soft tissues) to the obtained sizes of 9-9.5 cm. Normally, the transverse dimension is 11 cm. It is determined in the position of the pregnant woman on the back, and she presses her legs to the belly as much as possible. Oblique dimensions of the pelvis have to be measured with oblique basins. To identify pelvic asymmetry, the following oblique dimensions are measured: the distance from the anterior upper spine of one side to the posterior upper spine of the other side (21 cm); from the middle of the upper edge of the symphysis to the right and left posterior-upper spines (17.5 cm) and from the supercrescent fossa to the right and left anteroposterior spines (18 cm). Oblique dimensions of one side are compared with the corresponding oblique dimensions of the other. With a normal pelvic structure, the size of paired oblique sizes is the same. A difference greater than 1 cm indicates pelvic asymmetry. The lateral dimensions of the pelvis are the distance between the anterior-superior and posterior-superior spines of the iliac bones of the same side (14 cm), measured by its tazomer. The lateral dimensions must be symmetrical and not less than 14 cm. With a lateral conjugate of 12.5 cm, a birth is not possible. The angle of inclination of the pelvis is the angle between the plane of the entrance to the pelvis and the plane of the horizon. In the standing position of a pregnant woman, it is equal to 45-50. Determined using a special device - tazouglomera.
<< Ahead Next >>
= Go to tutorial content =

Measurement of pelvis size in pregnant women

  1. Rule number 2. Buy clothes size in size
    The second important rule of visual reduction of the figure is a careful selection of the dress by size. It would seem such a small thing! But I learned from my own experience that too tight clothing makes the body stick up and swim out in the most unaesthetic way. A short blouse of the wrong size will treacherously expose the stomach, which it is still too early to be proud of, too tight - it will tighten the folds of fat. Small
  2. Pelvic and pelvic injuries
    Examination 1. There are isolated fractures (pubic, sciatic, and iliac bones) and multiple fractures of the pelvic bones. 2. Multiple fractures are accompanied by massive blood loss in the retroperitoneal space and pelvic tissue with shock of varying severity. 3. For pelvic bone fractures, the most frequent complications are bladder ruptures and
  3. Breast size
    I have a small chest. Can this prevent me from successfully breastfeeding my baby? Not at all. Breast size does not affect the amount of milk it produces. Breast size is mainly determined by the amount of fat in it, and not the number of tissues that produce milk. Even if your breasts were small before pregnancy, they will increase during pregnancy and may even grow by
  4. Verse size
    The two syllable dimensions of Chorea are a two-syllable size with stress in the foot on the first syllable (the chorea foot diagram is?), And in the line as a whole - on the first, third, fifth, seventh, etc. In the sky, the clouds melt, And, radiant to the heat, In sparks the river rolls, Like a steel mirror. -? -? ________? - -? -? -? -? -? -? -? - -? -? -? -? Iamb is a two-syllable size with stress in the foot on the second syllable (foot diagram
  5. The size of the enterprise and its determinants
    Of great importance for the viability and competitiveness of the enterprise is determining its size. It is necessary to distinguish between the concept of "production size" and "enterprise size." The size of the volume of production is always expressed by the quantity of products, the more products the company produces in natural terms, the larger the size of production. Enterprise size is quantity
  6. The size of the female breast
    Often, women with small mammary glands think that they may not have enough milk. This is not true. Normally, the mammary glands are small. The larger the mammary gland, the greater part of it is adipose tissue. During pregnancy, the mammary glands develop and grow. The arteries and veins supplying them with blood also increase and protrude under the skin. When through
  7. Pelvic Organs
    Technique research. The pelvic organs are examined after extracting them in one complex. Having carefully examined the organs in situ, inject the first and second fingers of the left hand, the palm of the hand facing the organs of the small pelvis, behind the peritoneum between the bladder and the pubic joint, and tear the tissues connecting them with their fingers. Moving deeper, in a blunt way, separate the pelvic organs in front of
  8. Anatomy of the female pelvis
    The structure of the pelvic bone of a woman is very important in obstetrics, as the pelvis serves as the birth canal through which the born fetus moves. The pelvis consists of four bones: two pelvic, sacrum and tailbone. The pelvic (untitled) bone consists of three intergrown bones: the ileum, the pubic and the sciatic. The bones of the pelvis are connected by paired, almost immobile sacral tissue.
  9. Size and weight tables for normal organs
    For judgment at the opening of the change in the volume or size of the body, you must know the size of normal organs. Since the size of normal organs is highly variable, various authors provide different information. In the following tables, A.I. Abrikosov, the size and weight of normal organs are borrowed from various sources and can only be indicative. We have personal experience only in
  10. Selection of the sizes of the endotracheal tube and laryngeal mask
    Selection of the size of the endotracheal tube during tracheal intubation {foto17} In children under the age of 8–10 years, a tube without an inflatable cuff should be used. Selection of the size of the laryngeal mask {foto18} Estimation of lung damage {foto19} The number of points obtained should be divided by 4. Results: • ???? no lung damage - 0; • ???? moderate damage - 0.1-2.5;
  11. BONE Pelvis Anomalies
    Among the most common causes of violation of the physiological course of labor are various anomalies of the bone pelvis. Until the XVI century. there was a belief that the pelvic bones during childbirth diverge and the fetus is born, resting its legs on the bottom of the uterus. In 1543, the anatomist Vesalius, who first described the pelvis, established that the pubic bones are connected in the symphysis motionless. Arantius (1572) confirmed the opinion of Vesalius on
  12. Pelvic fracture
    Fracture of the pelvis is one of the most serious injuries, often accompanied by damage to internal organs and severe shock. Occurs when falling from a height, constriction, direct shocks. Signs: severe pain in the pelvic region with the slightest movement of limbs and a change in the position of the spine. Pathophysiology • As a rule, trauma occurs during hard shocks - car accidents,
  13. Fractures of the pelvic bones
    Fractures of the pelvic bones most often occur in road traffic accidents, falls, when there is a compression of the pelvis. Often, there is a violation of the continuity of the pelvic ring with damage to the large vessels, nerves, internal organs (bladder, rectum, uterus, etc.). The most common unilateral fractures of the anterior pelvis. CLINICAL PICTURE Forced position
  14. Fractures of the pelvic bones
    Fractures of the pelvic bones are serious injuries. Often they are accompanied by damage to the urethra and pelvic organs. Signs: change in the shape of the pelvis, inability to stand, walk, lift the leg. Victims often take the “frog” position - they lie on their backs with their legs bent, half-bent at the knee and hip joints. Possible shock. First aid.
  15. Features of the structure of the pelvis of females of different types of animals
    Features of the structure of the pelvis in cows The configuration of the pelvis in the cow is not very conducive to the flow of labor. The iliac bones rise almost at right angles. The entrance to the pelvis has the shape of an oval oblate from the sides. The transverse diameter of the pelvic cavity is less than the average transverse diameter of the entrance to the pelvis. Sciatic crests are highly developed. The exit from the pelvis is limited laterally by the ischial tubercles. Rough with
  16. APPLIANCE RADIATION OF THE PAZ IN ELEMENTED DOSES
    Sometimes during the operation of complete removal of the pelvic organs, a close connection is found between the tumor edge and the pelvic wall, or after the operation, the foci of the tumor tissue remain on the pelvic wall. In such situations, it is recommended to further irradiate the tumor bed, even if the patient has already completed the full course of remote and intracavitary radiotherapy. Physiological effects. After complete
  17. Floors of buildings, layout and size of premises
    Modern cities are characterized by high-rise housing construction, which is very economically advantageous. In new and reconstructed cities, residential areas are mostly built up with 9-12-storey houses. In the 6-storey and higher buildings should be equipped with an elevator and garbage chute. The big advantage of multi-storey buildings is the availability of all types of sanitary and domestic
  18. Pelvic abscess
    Pelvic abscess is a limited accumulation of pus in the vesicular-uterine or rectus-uterine space. Such abscesses can form during inflammatory saccular masses in the appendages, as well as in the postoperative period. At the same time, the formed adhesions delimit the accumulation of pus from the free sections of the abdominal cavity. Initially formed inflammatory
  19. Norms of areas and sizes of basic technological elements.
    The total area of ​​the stall room, m ?: Sob = 36 * 18 = 648 m? Useful (stall) area, m? Spol = 1,6 * 1 * 180 = 288 m? Specific useful area, m? Additional area, m? Sd. = 2.3 * 48 * 2 + 2 * 48 * 2 + 3.2 * 48 = 566.4 m? Area of ​​concrete floor, m? S concrete. floor = 648-288 = 360 m? The total cubic capacity of the room, m? S total cc = (D * W * H1) + (1 / 2H2 * W * D), where D is the length of the building; Sh -
  20. Features of placement and effective size of health care enterprises
    When analyzing the potential effectiveness of locating a health care company in any territory and evaluating the effects of survival factors, a number of sectoral peculiarities arise (Table 7): Table 7 - factors of placement of health care enterprises according to the survival criterion {foto14} * Mass consumption of medical services implies seeking medical care any
Medical portal "MedguideBook" © 2014-2016
info@medicine-guidebook.com