KHARKIV NATIONAL MEDICAL

UNIVERSITY
Department Of GYNAECOLOGY

FEMALE PELVIS AND

PHYSIOLOGY OF PREGNANCY
RAMASUBRAMANI INTHRESHH
GROUP 55
FACULTY 7
  The lower part of the abdomen that is located
between the hip bones in a female. The 
female pelvis is usually more delicate than, wider

FEMAL than, and not as high as the male pelvis. The angle

of the female pubic arch is wide and round. The

E
female sacrum is wider than the male's, and the 
iliac bone is flatter. The pelvic basin of the female
is more spacious and less funnel-shaped than the
PELVIS male's. From a purely anatomic viewpoint, the
female pelvis is better suited than the male pelvis to
accommodate a fetus during pregnancy and permit
the baby to be born.
•It protects and supports the pelvic contents, provides muscle attachment and facilitates the transfer of weight from trunk to legs in
standing, and to the ischial tuberosities in sitting.

•The cross-sectional anatomy of the female pelvis shows five bones: two hip bones, sacrum, coccyx, and two femurs. The joints
are supported by some of the strongest ligaments in the body which become laxer during pregnancy leading to increased joint
mobility and less efficient load transfer through the pelvis.

•The pelvic outlet at the base of the pelvis is narrower in its transverse diameter when compared with the pelvic inlet; it comprises
the pubic arch, ischial spines, sacrotuberous ligaments, and coccyx.

•Four pairs of abdominal muscles combine to form the anterior and lateral abdominal wall and may be termed the abdominal
corset.

•Transversus abdominis lies deep to the internal abdominal oblique and external abdominal oblique with the rectus abdominis
 central, anterior and superficial abdominal oblique, external oblique and transversus abdominis insert into an aponeurosis joining
in the midline at the linea alba.

•Organs of the female reproductive system present in the pelvis are subdivided into internal and external genitalia.

•The internal genitalia consists of the uterus, two uterine tubes, two ovaries, and the vagina. The external genitalia mainly consists
of the mons pubis, clitoris, labia majors, labia minora, and Bartholin glands
 1.Gynaecoid pelvis: (50%)
 It is commonly known as
the female pelvis because that
type occurs most frequently in
women.
 Most suitable for
TYPES
childbirth.
 Wider brim.
 Ischial spines are blunt
OF
 Sub pubic angle is 90º
2.Anthropoid pelvis: (25%)
PELVIS
 It favors a posterior
position of the fetus.
 Oval in shape
 Transverse diameter is
shorter
 Seen in tall women with
narrow shoulders
3.Android pelvis: (20%)
 It is commonly known as male
pelvis because it occurs more
frequently in men.
 Heart shaped brim
 Anterior posterior diameter is
shorter
 Transverse diameter is wider
 Childbirth is difficult
4.Platypelloid (flat) pelvis: (5%)
 This type of pelvis is rare. 
Kidney shaped brim
 Anterior posterior diameter is
smaller
 Transverse diameter is wider
 Not conductive to vaginal
delivery
FEMALE PELVIS CONDITIONS
The pelvis contains a large number of organs, bones, muscles, and ligaments, so many
conditions can affect the entire pelvis or parts within it. Some conditions that can affect the
female pelvis as a whole include:

Pelvic inflammatory disease (PID). PID is an infection that occurs in the female reproductive
system. While it’s often caused by a sexually transmitted infection, other infections can also cause
PID. Untreated PID can lead to complications, such as infertility or ectopic pregnancy.

Pelvic organ prolapse. Pelvic organ prolapse occurs when the muscles in the pelvis can no
longer support its organs, such as the bladder, uterus, or rectum. This can cause one or more of
these organs to press down on the vagina. In some cases, this can cause a bulge to form outside of
the vagina.

Endometriosis. Endometriosis occurs when the tissue that lines the inside walls of the uterus
(endometrium) begins to grow outside of the uterus. The ovaries, fallopian tubes, and other tissues
in the pelvis are typically affected by the condition. Endometriosis can lead to complications,
including infertility or ovarian cancer.
 pain in the lower abdomen or pelvis

a feeling of pressure or fullness in the pelvis

SYMPTOM unusual or foul-smelling vaginal discharge

S OF pain during sex

PELVIC bleeding in between periods

CONDITIO painful cramping during or before periods

NS pain during bowel movements or when urinating

a burning feeling when urinating

  Contracted pelvis
 Rachitic pelvis
 Asymmetrical pelvis
 Roberts pelvis
DEFORMITI  Nageles pelvis
ES OF Osteomalacis/ maacosteon pelvis
PELVIS  Assimilation pelvis
Others-Kyphosis, scoliosis,
spondylosisthesis
  Pregnancy and its changes is a normal physiological
process that happens in all mammalian in response
to the development of the fetus. These changes
happen in response to many factors; hormonal
 changes, increase in the total blood volume, weight
PHYSIOLOGIC gain, and increase in fetus size. All these factors
AL CHANGES have a physiological impact on all systems of the
IN pregnant woman; musculoskeletal, endocrine,
PREGNANCY reproductive system, cardiovascular, respiratory,
gastrointestinal system, and renal changes. The full
pregnancy period is about 40 weeks when the
delivery happens before 37 weeks it is called a
premature baby.
Changes in genital Haematological
Weight gain CVS changes
organ Changes

Urinary system Metabolic

RS changes GIT Changes
changes changes

Endocrine
Changes in skin
changes
1.Changes in Genital organ 

 Uterus 
 Size – increases                                                                                    
 Due to Hypertrophy & hyperplasia of myometrium. 
 Weight – changes from 30-50 to 1000-1200 gms 
 Length – 7.5 to 35 cm 
 Thickness from 1.25 cm to 5 mm 
 Volume – few ml to 5-7 lit 
 Shape – Pyriform to globular.

 Ovaries 
 First 12- 16 weeks corpus leuteum enlarges 
 Then as HCG levels decreases it degenerate 
 Its function taken over by placenta.
 Cervix 
 Endocervix – hypertrophied 
 Cervical gland secretions increases form a plug which closes cervix 
 Tough cervix becomes soft. 

 Fallopian tubes 
 Due to enlargement of uterus – pushed upwards 
 Blood supply increases 
 Causes hyperplasia of epithelial cells. 

 Mammary glands. 
 Hyperplasia of ductal & alveolar tissue 
 Areola – Pigmented.  Sebaceous glands becomes prominent in areola 
 Nipples become larger & pigmented. 

 2.Weight gain 
 Total weight gain – 10-12 kg. 
 Fetus – 3kg 
 Placenta & amniotic fluid – 1.5 kg 
 Uterus & breast enlargement – 1.5 kg 
 Blood volume & interstitai fluid 1.5 kg 
 Fat deposition- 3-4 kg. 
3.Haematological Changes 

Blood volume –      30% 

Blood indices - 
Plasma proteins 
Leucocytes 
Platelets 
Coagulation factors    (VII,VIII,IX & X) 

4.Cardiovascular System changes 

Position of heart – more laterally & upward & LAD 

Heart rate – Tachycardia (Hyperdynamic circulation) 
Cardiac output -    due to blood volume 
Blood pressure – both decreases mainly due to vasodilation. 
Venous pressure – due to gravid uterus rises causes oedema of feet, varicose veins, piles &
peripheral thrombosis. 
Blood flow -     to uterus, kidney & skin.
5.Respiratory System changes  

Anatomical changes – Diaphragm

elevation 
Hyperventilation – progesterone increases
sensitivity to CO2 -
Ventilatory functions -   TV & IC and     
RV & FRC 
Gas exchange    due to    pulmonary blood
flow 
Oxygen consumption by    15%.
6.Urinary system changes 

Renal blood flow 

Effective renal plasma flow 
GFR 
Renal tubular absorptive capacity 
Clearance rate 
Glycosuria 
Proteinuria 
Water balance 
Acid base balance Hyperventilation causes respiratory
alkalosis
7.GIT Changes  8.Metabolic changes 

GIT secretion & motility  BMR – 

Gall bladder function  Protein metabolism – nitrogen
Liver function – albumin retention & positive nitrogen
fibrinogen   balance 
Morning sickness – anorexia, Carbohydrate -    BSL,
glycosuria,    hepatic glycogen. 
nausia & vomiting. 
Fat -     in cholesterol, TG, PL 
GTT – Diabetic type
Mineral -    Ca & P retention,
iron metabolism.
9.Endocrine changes  10.Changes in skin. 

Pituitary -      prolactin, ACTH, Hyperpigmentation –

TSH &     GnRH  cloasma,
linea alba, 
Thyroid -     thyroid binding
globulin. 

Parathyroid -     active form of

Vit D3 
Stria
Adrenal cortex -     all  gravidarum – 
linear scar on
lower abdomen
Pancreas -    Insulin.
 Pelvic floor dysfunction.
Rib pain.
PROBLEM Nerve compression syndromes.
S MAY Carpal tunnel syndrome.
HAVE Muscle cramps.
DURING Symphysis pubis dysfunction
Morning sickness.
PREGNAN
Edema.
CY
Pre-eclampsia
Back pain.
 Cardiovascular

Respiratory

Renal or thyroid disease

Diabetes (type 1, if poorly controlled)

TI The history of miscarriage, premature labour, et al growth restriction,

CA
DI Cervical incompetence;

IN
RA S Hypertension,

NT O N
CO
Vaginal bleeding,

Reduced fetal movement,

Anaemia,

Breech presentation,

Placenta praevia
 Craving for particular food 
PSYCHOLOGI
Alterartion in behaviour, emotion &
CAL
mood
CHANGES 
In some cases true Psychosis.
  All women should stop exercising immediately:
 abdominal pain

SIO   vaginal bleeding

LU  shortness of breath

NC    Dizziness

CO N  Faintness
 persistent severe headache
  palpitations or tachycardia;PGP, which may
also lead to difficulty in walking.
THANK YOU