Well come to your Department

you save double life at a moment

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 Reproductive Anatomy and
Physiology

Abera. H (MSc in CMW/OB-GYN/)

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Course Contents
Pelvic region /female pelvis/
Anatomy &physiology of female
reproductive organ
Anatomy & Physiology of Male
reproductive organ
Fetal Skull & the Diameters

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Course Contents
Pelvic region /female pelvis/.4hrs
Anatomy &physiology of female
reproductive organ16hrs
Anatomy & Physiology of Male
reproductive organ..8hrs
Fetal Skull & the Diameters.4hrs

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Female Pelvis

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 Female Pelvis

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Learning objectives

By the end of this session, you will be able to

discuss about;
Forming structures of female pelvis
Three regions of true pelvis
Pelvic diameters
Pelvic conjugates
Pelvic joints and ligaments
Pelvic floor
Types of female pelvic bones

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 Female pelvis
Function of Pelvic bone;
Allow the movement of body
Adapted for child bearing
Transmits the weight of body to the trunk
Takes the weight of the body when sitting
Protect pelvic organs(urinary bladder ,uterus
,oviduct &ovary)
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Female pelvis
Female pelvis is a strong bony ring w/c forms an
essential part of the skeletal frame work for the
passage of the fetus during the process of birth.
The pelvis is composed of four bones;
2 innominate or hip bone (illium,ischium&pubis)
The sacrum
The coccyx

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Female pelvis
ILLIUM

Is the large outer part

The concave anterior surface is known as
iliac fossa
The upper curved border is iliac crest
The terminal points of ilium are anterior
and posterior iliac spine

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 Female pelvis
ISCHIUM
Is the lowest part of the innominate bone
The large prominences on both lateral parts of
innominate bone are ischial tuberosities where
the body rests in sitting position
Posterior and superior to the tuberosities a
projected area is called ischia spine w/c is a
useful land mark during labour; the station or
level of fetal head is being assessed.

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Female pelvis
PUBIS BONE

Is located on the anterior part of the pelvis

It has body, superior &inferior rami
The left and right inferior rami at symphsis (the
two pubic bones meet) forms the pubic arch
It is important to assess the adequacy of pelvic
outlet.
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Female pelvis
SACRUM
Is five fused vertebra makes parts of pelvic bone
Its shape is curved and irregular (upper part is wide and
lower narrow)
Parts of sacrum
Ala or wing of sacrum
Sacral promontory
Sacral foramina-four pairs of holes where sacral
nerves pass through it.
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Female pelvis
COCCYX

Four fused vertebra (triangular in shape)

Vestigial bone
It provides space by back ward movement
during the birth of the baby.

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 Female pelvis
Female pelvis has two parts
False Pelvis (the part above the circle)
True Pelvis (below the circle)- through w/c the
baby negotiates during labor & birth.
True pelvis is divided into three regions
Pelvic brim (inlet)
Pelvic cavity
Pelvic outlet
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 Female pelvis
1. PELVIC BRIM
It is used to assess descent and engagement of the presenting part
Important land marks of pelvic inlet

1. Sacral promontory

2. Ala of sacrum
3. Sacroiliac joint
4. Iliopectineal line
5. Iliopectineal eminence
6. Superior ramus of the pubic bone
7. Upper inner border of the body of the pubic bone
8. Upper inner border of the symphysis pubis
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Female pelvis.

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 Female pelvis
Pelvic brim diameters
1. Anterior-posterior diameter;
Measured form the sacral promontory to the
upper border of symphysis pubis
2. Oblique diameter;
Measured from one sacro-iliac joint to the
iliopectineal eminence on the opposite side of the
pelvis
nTransverse diameter;

1. is a line between the points furthest apart on the

iliopectineal lines
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Female pelvis.

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 Female pelvis
2. PELVIC CAVITY
Extends from the brim to the outlets of the pelvis
It facilitates the descent and rotation of the
presenting part
Its slope controls the speed of the birth and
therefore reduces sudden pressure changes on the
fetal head.
The level of ischial spines makes the mid plane or
midpoint of the pelvis
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Female pelvis
3. PELVIC OUTLET
Is diamond shaped
Anatomical boundaries of the outlet are formed by;
Tip of coccyx
Sacro-tuberous ligament
Ischial tuberosities
And pubic arch
The obstetric outlet is bounded by
The inner border of the base of the sacrum
Sacro-spinous ligament
Ischial spine
The lower inner border of the symphsis pubis
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Outlet diameter

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Diameters of the pelvis

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 PELVIC CONJUGATES
Conjugate is a measurement taken from one point in
the pelvis to another.
In obstetrics there are three conjugates
1. Anatomical or true conjugate -is measured from
sacral promontory to upper outer border of
symphysis pubis ~ 11cm
2. Diagonal conjugate is measured from sacral
promontory to inferior surface of symphysis
pubis ~ 12cm
3. Obstetric conjugate is obtained by subtracting
1.5cm from diagonal conjugate ~ 10cm
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Cont..

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 Measurement of Diagonal Conjugate

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PELVIC JOINTS AND LIGAMENTS

Pelvic ligaments are; Pelvic joints are;

Itra -pubic ligament Two sacroiliac joints
Sacroiliac ligament-strongest One sacro-coccygeal joint
ligament in the body One symphsis pubis
Sacrotuberous ligament
Sacrococcygeal ligament

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PELVIC JOINTS AND LIGAMENTS

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 Pelvic floor
Pelvic floor is a muscular partition which separates
the pelvic cavity from the anatomical perineum.

It consists of three sets of muscles on either side

pubococcygeus, iliococcygeus and ischiococcygeus
and these are collectively called levator ani.

Its upper surface is concave and slopes downwards,

backwards and medially and is covered by parietal
layer of pelvic fascia. The inferior surface is convex
and is covered by anal fascia.
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Levator ani Muscles

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Shapes

of female pelvis
Based on the shape and size of pelvic inlet the
following four types of female pelvis are
distinguished.
1. Gynecoid pelvis:
Typical female pelvis
Found in 50%
the inlet is oval with TD > AP diameter
Straight pelvic sidewalls with roomy pelvic
cavity & Pubic arch is wide
Ischial spines are not prominent
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 Cont
2. Android pelvis:
Male like pelvis
Found in 23-32%
funnel shaped pelvis with a heart shaped inlet
and contracted outlet
AP diameter is short- pelvic cavity is small
Sub pubic angle ~70o
in such pelvis arrest of fetal head may occur
during delivery(CPD)
Prominent spines
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 Cont
3. Anthropoid pelvis:
Ape like pelvis
Found in 23-28%
Long narrow and oval in shape
At the inlet there is a long AP diameter
and short transverse diameter
Pelvic brim APD > TD

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 Cont..
4. Platypelloid:
kidney shaped pelvis
Found in 2-5%
Flattened at the inlet (Pelvic brim TD >AP)
transversely oval with a short AP diameter at
inlet and out let.
Sub pubic arch is wide
Delivery in such pelvis is usually difficult

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Cont..

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The type of female pelvis differs in:
-Shape of the pelvic inlet
-Shape of the side-walls
-Character of the sub pubic arch
Characteristics Gynecoid Android Anthropoid Pletypelloid

Brim Round Heart shaped Long oval Kidney shaped

Fore-pelvis Generous narrow narrowed wide

Side wall straight convergent divergent divergent

Ischial spines blunt prominent blunt blunt

Sciatic noch Round narrow wide wide

Sub pubic angle 900 <900 >900 >900

incidence 50% 23-32% 23-28% 2-5%

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