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    Clinical Pelvimetry

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    Victor-Gabriel Rugina
    Pelvimetry means to measure the pelvis. X-ray Computerised tomography (CT) Magnetic resonance imaging (MRI) pelvic inlet mid-cavity pelvic outlet.

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    Clinical Pelvimetry

    Uploaded by

    Victor-Gabriel Rugina
    2K views24 pages
    Pelvimetry means to measure the pelvis. X-ray Computerised tomography (CT) Magnetic resonance imaging (MRI) pelvic inlet mid-cavity pelvic outlet.

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    © Attribution Non-Commercial (BY-NC)

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    Pelvimetry means to measure the pelvis. X-ray Computerised tomography (CT) Magnetic resonance imaging (MRI) pelvic inlet mid-cavity pelvic outlet.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2K views24 pages

    Clinical Pelvimetry

    Uploaded by

    Victor-Gabriel Rugina
    Pelvimetry means to measure the pelvis. X-ray Computerised tomography (CT) Magnetic resonance imaging (MRI) pelvic inlet mid-cavity pelvic outlet.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    The document discusses different methods of measuring the pelvis including clinical, external, internal and imaging pelvimetry. It provides detailed protocols and measurements for assessing different areas of the pelvis.

    The different types of pelvimetry discussed are clinical pelvimetry which includes internal and external pelvimetry, and imaging pelvimetry using x-ray, CT or MRI.

    During internal pelvimetry of the pelvic inlet, measurements taken include the diagonal conjugate, anteroposterior diameter, and palpation of structures like the sacral promontory.

    Clinical Pelvimetry

    Xiu Xiu Jiang

    Womens Hospital

    Zhejiang University

    INTRODUCTION

    pelvi- Latin word pelvis (basin) metron - Greek word for measure pelvimetry means to measure the pelvis.

    Womens Hospital, Zhejiang University

    INTRODUCTION
    Clinical pelvimetry: Internal pelvimetry (manually ) pelvic inlet mid-cavity pelvic outlet External pelvimetry Pelvimeter pelvic inlet pelvic outlet Imaging pelvimetry: X-ray Computerised tomography (CT) Magnetic resonance imaging (MRI)

    Womens Hospital, Zhejiang University

    METHODS

    A protocol of clinical pelvimetry

    Womens Hospital, Zhejiang University

    INTRODUCTION

    Pelvic inlet

    anteroposterior 11cm transverse 13cm oblique 12.5cm

    Womens Hospital, Zhejiang University

    INTRODUCTION
    Three anteroposterior diameters of the pelvic inlet

    true conjugate obstertrical conjugate diagonal conjugate

    Womens Hospital, Zhejiang University

    Internal pelvimetry ------ anterposterior diameter of Pelvic inlet

    Diagonal conjugate (DC) 12.5~13cm Obstetrical conjugate = DC -1.5 ~ 2cm

    11.5cm

    METHODS
    A protocol of internal pelvimetry pelvic inlet

    Womens Hospital, Zhejiang University

    External pelvimetry pelvic inlet


    external conjugate

    18cm

    The distance in a straight line between the depression under the last spinous process of the lumbar vertebrae and the upper edge of the pubic symphysis

    left lateral position - upper leg: extend lower leg: flex

    External pelvimetry pelvic inlet


    interspinal diameter, IS

    23-26cm

    between the anterior superior iliac spines.

    supine position intercristal diameter, IC

    25-28cm

    between the most far points on the outer borders of the iliac crests

    summary
    Pelvic inlet Palpation of the pelvic brim: The index and middle fingers are moved along the pelvic brim. Note whether it is round or angulated . Diagonal conjugate: Try to palpate the sacral promontory to measure the diagonal conjugate. Normally, it is 12.5 cm and cannot be reached. If it is felt the pelvis is considered contracted and the true conjugate can be calculated by subtracting 1.5 cm from the diagonal conjugate .This assessment is not done if the head is engaged.

    Womens Hospital, Zhejiang University

    INTRODUCTION

    Transverse diameter of the midpelvis

    Bispinous diameter = 10 cm between the tips of ischial spines

    Womens Hospital, Zhejiang University

    METHODS

    A protocol of clinical pelvimetry

    Womens Hospital, Zhejiang University

    Summary
    The mid-cavity Shape and inclination of the sacrum. Side walls: To determine whether it is straight, convergent or divergent Ischial spines: Whether it is blunt (difficult to identify at all), prominent (easily felt but not large) or very prominent (large ) The ischial spines can be located by following the sacrospinous ligament to its lateral end. Interspinous diameter: By using the 2 examining fingers, if both spines can be touched simultaneously, the interspinous diameter is 9.5 cm i.e. inadequate for an average-sized baby. Sacrosciatic notch: If the sacrospinous ligament is two and half fingers, the sacrosciatic notch is considered adequate.
    Womens Hospital, Zhejiang University

    INTRODUCTION

    Antero-posterior diameter =11.5cm Transverse diameters = 9 cm Anterior sagittal diameter = 6 cm Posterior sagittal diameter = 8.5 cm

    Womens Hospital, Zhejiang University

    METHODS

    A protocol of clinical pelvimetry

    Womens Hospital, Zhejiang University

    METHODS

    Bituberous diameter

    Angle of Pubic arch

    Womens Hospital, Zhejiang University

    SUMMARY
    Pelvic outlet Subpubic angle: Normally, it is 90 Bituberous diameter: Normally, it admits the closed fist of the hand (4 knuckle). Mobility of the coccyx. by pressing firmly on it while an external hand on it can determine its mobility. Anteroposterior diameter of the outlet: from the tip of the sacrum to the inferior edge of the symphysis (>11.0 cm)

    Womens Hospital, Zhejiang University

    SUMMARY

    Data pelvic brim Diagonal conjugate Symphysis Sacrum Side walls Ischial spines Interspinous diameter Sacrosciatic notch Subpubic angle Bituberous diameter Coccyx Anterposterior diameter of outlet

    Finding Round. 11.5 cm. Average thickness, parallel to sacrum. Hollow, average inclination. Straight. Blunt. 10.0 cm. 90 4 knuckles (> 8.0 cm). Mobile. 11.0 cm.

    Womens Hospital, Zhejiang University

    INTRODUCTION

    Imaging pelvimetry: X-ray Computerised tomography (CT) Magnetic resonance imaging (MRI)

    Womens Hospital, Zhejiang University

    METHOD

    A clinical case of contracted pelvis

    Womens Hospital, Zhejiang University

    Figure 1a Midsagittal

    section shows the obstetric conjugate of 8.9 cm and sagittal outlet of 7.6 cm.

    Keller T M et al. Radiology 2003;227:37-43

    2003 by Radiological Society of North America

    sections show the interspinous distance of 8.4 cm, measured at the level of the foveae of the femoral heads (arrows)

    Figure 1b Transverse

    Keller T M et al. Radiology 2003;227:37-43

    2003 by Radiological Society of North America

    Figure 1c Transverse

    sections show the intertuberous distance of 8.3 cm

    Keller T M et al. Radiology 2003;227:37-43

    2003 by Radiological Society of North America

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