Female pelvis and foetal skull

DR.Mohd Rafa
January 2020 12
• Knowledge of the anatomy of the normal
female pelvis; fetal skull, soft tissues is
essential to understanding the mechanism of
labour.
• The pelvis is divided into:
– pelvic brim or inlet
– pelvic midcavity
– pelvic outlet
– pelvic floor
 The pelvic brim or inlet
NB: pelvis sometimes divided by pelvic inlet into true and false
pelvis
It is bounded by :
– In front by symphysis pubis
– on each side by upper margin of pubic bone, iliopectineal
line; ala of sacrum
– posterior by promontory of sacrum.

NB: normal transverse diameter 13cm which wider than ant-

post diameter 11cm.
 Pelvic midcavity

It is bounded by
• in front by middle of symphysis pubis
• on each side by pubic bone ; obturator fascia; inner aspect of
ischial bone and spines
• posterior by junction of 2nd and 3rd pieces of sacrum

NB: The cavity almost round as transverse and ant-post equal

12cm

• Ischial spines are palpable vaginally and used as landmarks to

asses the descent of head in labour {station} and also used as
landmark in anaesthetic block for pudendal block.
 The pelvic outlet

It is bounded by:
• in front by lower margin of symphysis pubis
• on each side by descending ramus of pubic bone, ischial
tuberosity and sacrospinous ligament
• posterior by last piece of sacrum

NB: ant-post diameter 13.5cm and tranverse 11cm

 The pelvic floor

• formed by two levator ani muscles which with

their fascia form musclofascial gutter during
the 2nd stage of labour
 The fetal skull
• Formed by bones, sutures, fontanelles .

The fetal skull is made up of

• the vault
• face
• the base

The bones that form the vault are :

• Parietal bones.
• parts of frontal, occipital, temporal bones.
B/W these bones there are four membranous
sutures:
• sagittal
• frontal
• coronal
• lambdoid
Fontanelles are the junction of various sutures
• The anterior fontanelle /bregma
– Diamond shaped
– at junction of the sagittal, frontal and coronal
sutures
• The posterior fontanelle
– triangular shaped
– at junction of sagittal and lambdoid suture b/w
two parietal bone and occipital bone
• THE VERTIX is the area of skull bounded by :
– Two parietal eminences
– Anterior fontanelle
– Posterior fontanelle
 The diameters of the skull
• The fetal head is ovoid in shape
There are different longitudinal diameters that
may present in labour depending on the
attitude of the fetal head
1. well deflexed head { vertex }
– suboccipito-bregmatic --- 9.5cm
– measured from suboccipital region to center of
ant.fontanelle
2. less flexed head { occipito-posterior }
– suboccipito-frontal --- 10cm
3. more extended head { occipito-
frontal }
– From root of nose to post.fontanelle --- 11.5cm
4. greatest longitudinal diameter { brow }
– mento-vertical ---13cm
– measured from chin to vertix
5. submento-bregmatic diameter---face
– The head is extended but to smaller diameter
– measured from below the chin to anterior
fontanelle ---9.5
THANKS•