What Is Pelvic Ultrasonography?

A narrow pelvis is a condition that refers to a small antenatal pelvic measurement entrance diameter, or a primiparous woman approaching the due date without the child's head entering the pelvis.

Narrow pelvis

A narrow pelvis is a condition that refers to a small antenatal pelvic measurement entrance diameter, or a primiparous woman approaching the due date without the child's head entering the pelvis.

nickname

Narrow pelvis

Visiting department

Obstetrics and Gynecology

Common causes

Osteomalacia

Common symptoms

The primipara is approaching the due date and the child is not in the pot

Diagnostic check

Pay attention to rickets

Narrow pelvis

Obstetrics and Gynecology

The antenatal pelvic measurement has a small entrance diameter, or the primipara is near the due date and the child does not enter the pelvis.

1. Medical history pay attention to rickets, osteomalacia, bone and joint tuberculosis, and history of bone trauma. The pregnant woman must know whether there is a previous history of dystocia, the weight of the newborn, and the postnatal situation.

2. The antenatal pelvic measurement entrance diameter is small, or the first-born woman is approaching the due date and the child does not enter the pelvis, the following checks should be made: measuring the internal diameter of the sacrum (that is, the diagonal diameter of the pelvis), should be measured before 36 weeks of pregnancy ( Normal 12.5cm). Estimate fetal size. Pay attention to whether there is draping abdomen and riding on the child's head.

3. Middle pelvic stenosis. Digital rectal examination of the sciatic spine (normally only palpable or not protruding), width of sciatic notch (sacral spinal ligament, normal> 2 transverse fingers or 3 cm), cohesion of the pelvic wall, sacral morphology (normally moderate curvature), and Tail joint condition (normally slightly movable).

4. For those with a small pelvic outlet diameter, check the pubic arch angle (normally 85 °). Fist between the two ischial tuberosities with your hands and push them upwards. Normal people can pass.

5. Those who suspect the tilt of the pelvis, check: bilateral external oblique diameter, normal difference <lcm. The pregnant woman stands and observes the rhombus, the two side angles of the normal are symmetrical. The pregnant woman lies on her back with her legs straight.

6. Ultrasound survey to measure the head diameter and pelvic inner diameter.

7. Make X-ray pelvic measurements when necessary to understand the shape of the pelvis and measure the inner diameter; measure the pelvic ratio when in the head position.

1. The diameter of the pelvis is significantly reduced, or those with obvious deformities and pelvis disproportion, undergo cesarean section.

2. Mild narrow pelvic entrance can be trial production. Observe 6 to 8 hours after the beginning of regular contractions. If the birth process is smooth and the mother and baby are in good condition, vaginal delivery can be performed. Otherwise, cesarean section is performed.

3. Most of the pelvic stenosis is found during labor. If the contractions are good and the uterine opening is widened quickly, but the fetal head always stays above the level of the sciatic spine, a cesarean section should be performed.

4. When the transverse diameter of the exit is less than 8cm, and the sum of the diameter of the ischial tuberosity and the sagittal diameter of the exit is less than 15cm, it is not suitable for trial production, that is, cesarean section.

5. Trial production is not allowed in the following cases. Firstborn women over 35 years old. The pelvis was significantly disproportionate or the fetal position was not correct. People who have stillbirth, cesarean section or failed trial delivery in the past. Look forward to having children or larger fetuses. Those who have other complications must shorten the labor process.

6. Attentions during trial production are as follows: The consent of the family and the mother must be obtained, and the possible consequences must be explained. Closely observe the progress of labor and pay attention to whether the contractions are consistent with the decline of the child's head and the dilatation of the uterine opening; if the contractions are regular and the fetal head does not show a downward trend, or the fetal heart changes, or the uterine tenderness, stop trial production and cesarean section Production.

Attention during trial production:

1. The consent of the family and the mother must be obtained, and the possible consequences must be explained.

2. Closely observe the progress of labor and pay attention to whether the contractions are consistent with the decline of the child's head and the dilatation of the cervix; if the contraction law does not show a downward trend in the fetal head, or there is a change in the fetal heart, or there is tenderness in the uterus, stop trial production and cut Miyako.