MATERNAL

PELVIS
FEMALE BONY
PELVIS
The pelvis is a hard ring of bone, which
supports and protects the pelvic organs
and the contents of the abdominal
cavity. The muscles of the legs, back and
abdomen are attached to the pelvis, and
their strength and power keep the body
upright and enable it to bend and twist
at the waist, and to walk and run.
 FOUR PLANES AND
DIAMETERS OF PELVIS
Plane of pelvic Plane of greatest
inlet or superior pelvic dimension
strait

Plane of midpelvis or Plane of Outlet or

least pelvic Inferior strait
dimension
 TRUE PELVIS
Anterior wall and posterior walll of the pelvis measures 5cm and 10cm
respectively.
In the standing position, upper part of pelvic canal is directed
downwards and backwards and the lower part curves and is directed
downwards and forwards
The true pelvis is divided into 3 parts:
1. Inlet
2. Cavity
3. Outlet
Boundaries:
Posteriorly by: Sacral Promontory and a
lae of the sacrum
Laterally by: Linea terminalis
Anteriorly by: Horizontal rami of pubic
bones and pubic symphysis
Typically round than ovoid

PELVIC INLET
DIAMETERS
1. Anteroposterior diameter
a. OBSTETRIC CONJUGATE (10.5cm) - Shortest distance from
symphysis pubis to the middle of sacral promontory
i. Most important AP diameter
ii. Presenting part of fetus should pass through it
b. TRUE CONJUGATE/ANATOMIC
CONJUGATE/CONJUGATE VERA (11 cm) - distance from
middle of sacral promontory to the superior surface of the
pubic symphysis.
DIAMETERS
Anteroposterior diameter
C. DIAGONAL CONJUGATE (12.5cm) - extends from subpubic
angle to the middle of sacral promontory
Importance:
1. can be measured clinically
2. Subtracting 1.5cm from this gives obstetric conjugate
3. The inlet is adequate for a normal fetus if the diagonal conjugate
is 12cm or more.
2. TRANSVERSE DIAMETER (13.5CM)
Widest distance between iliopectineal lines
Widest diameter of the inlet Most fetuses engage in transverse or
oblique diameter

3. OBLIQUE DIAMETERS (12.5CM)

Extends from sacroiliac joint of one side to opposite iliopectineal
eminence

4. POSTERIOR SAGGITAL DIAMETERS (5CM)

Extends from point of intersection of obstetric conjugate and transverse
diameter to middle of sacral promontory

5. SACROCOTYLOID DIAMETER (9.5CM)

Distance between the midpoint of sacral promontory and the ipsilateral
iliopectineal eminence
 MIDPELVIS
Most important plane of the pelvis at the level of the ischial spines
Cardinal movements of engagement and internal rotation occur here
Bounded by 4th and 5th sacral vertebrae, white line, ischial spines, sacrospinous
ligaments and pubic symphysis.

DIAMETERS:
1. Anteroposterior diameter (11.5cm) - extends from junction of 4th and 5th sacral
vertebrae to the lower border of pubic symphysis
2. Transverse diameter (10.5cm) - between ischial spine
3. Posterior sagittal diameter (6cm) - extends from the interspinous diameter to the
junction of the 4th and 5th sacral vertebrae
Made up of 2 triangles with a common base (a line drawn through 2 ischial tuberosities
The anterior triangle has the subpubic angle as the apex and the pubic rami and ischial
tuberosities as the sides
Diameters:
1. Anterior diameter (12cm) - extends from lower margin of pubic symphysis to the
sacrococcygeal junction
2. Transverse Diameter (10.5cm)- Distance between inner edges of ischial
tuberosity.
3. Posterior sagittal diameter (7cm) - extends from middle of transverse diameter
to the saccrocygeal junction

PELVIC OUTLET
 CLASSIFICATION OF PELVIS
GYNECOID PELVIS
Inlet is slightly OVAL or ROUND (transverse diameter equal to
or greater than AP diameter. SPINES ARE NOT PROMINENT.
OUTLET pubic arch is WIDE. Ideal for VAGINAL DELIVERY.

ANDROID PELVIS
At the inlet, posterior sagittal diameter < Anterior sagittal diameter
In the medpelvis, sidewalls are convergent, ischial spines are prominent
At the outlet, subpubic arch is narrow
Typical MALE PELVIS. HEART SHAPE
CLASSIFICATION OF PELVIS
ANTHROPOID PELVIS
At the inlet, AP diameter > Transverse diameter
In the midpelvis, sidewalls are convergent, ischial spines are likely to be
prominent
At the outlet, subpubic arch is narrowed, but well shaped
associated with occipito - posterior position during labor

PLATYPELLOID PELVIS
Flattened gynecoid pelvis with a short Anteroposterior
and a wide transverse diameter
 CLINICAL PELVIMETRY
Measuring the adequacy of the
maternal pelvis for vaginal delivery.
Middle finger reach the sacral
promontory measures the
diagonal conjugate.
Subtract 1.5 - 2 cm to obtain
the OBSTETRIC CONJUGATE.
Put a fist between the ischial
tuberosity to measure the
transverse diameter, a
dimension of 8.5 cm diameter
is adequate.
Small measurement results to
obstructed labor.
Suboccipitobregmati
c (9.5cm) -
is the presenting
anteroposterior
diameter when the
head is well flexed. It
extends from the
undersurface of the
occipital bone to the
center of the bregma