A narrow pelvis is a specialized concept used only in obstetric practice, which includes the features of the structure of the pelvic bones of a woman in labor or pregnant.
CAUSES OF A NARROW PELVIS
The main reason leading to the development of such a pathology as a narrow pelvis is a violation of the intrauterine development of a girl, when improper nutrition of the mother provokes improper formation of bones, and pelvic bones, including in the fetus.
Risk factors that provoke a violation of the correct formation of pelvic bones:
substandard living conditions;
shortening of the lower limb;
malnutrition;
polio;
traumatic effect on pelvic bones, lower extremities and spine;
rickets and heavy workloads in childhood;
severe stress;
excessive physical activity;
wearing tight clothes during pregnancy;
short stature of a woman;
TYPES OF NARROW PELVIS
The concept of a narrow pelvis has two varieties:
Anatomically narrow pelvis. It is diagnosed when a decrease in its size is detected compared to normal indicators, even by a few centimeters.
Clinically narrow pelvis. It is diagnosed when there is a discrepancy between the size of the pelvis of the woman in labor and the fetal head. It can be determined even with the normal size of the pelvis, if the fetus is large. If the fetus has a small size with an anatomically narrow pelvis, a clinical narrow pelvis is not diagnosed.
For a successful delivery, timely detection of a narrow pelvis is necessary to save the life of the woman in labor and the child.
SYMPTOMS OF A NARROW PELVIS
A narrow pelvis has no effect on the course of pregnancy, and can only manifest itself when childbirth occurs. This condition is established with the help of special measurements carried out by a midwife or a doctor.
Symptoms of a narrow pelvis in childbirth:
Painful contractions that do not lead to the advancement of the fetus.
Lack of synchronicity in the opening of the cervix and the promotion of the fetus.
Edema of the external genitalia and cervix.
Lack of independent urination in a woman in labor.
Soreness in the lower segment of the uterus.
DIAGNOSIS OF A NARROW PELVIS
Collecting anamnesis of the life of a woman in labor. Identification of injuries, operations and diseases that she suffered in childhood and adolescence. It is necessary to pay special attention to the presence of rickets, injuries of the lower extremities and pelvis, spinal pathologies.
Collection of gynecological anamnesis, with detailed information about the beginning of menstruation, their regularity, existing pregnancies and childbirth, weight, already born children.
General examination: weight, height of the pregnant woman, abdominal shape, joint mobility, visible curvature of the spine.
Radiology data clarifying the internal dimensions of the pelvis (this study is carried out after the 38th week).
ultrasound to clarify the internal dimensions of the pelvis.
In childbirth, the diagnosis of a clinically narrow pelvis is confirmed on the basis of a certain list of signs:
At the beginning of labor, the fetal head is not pressed against the entrance to the pelvis. This condition is determined using the Leopold technique – an external examination, which determines the mobility of the fetal head.
Belated outpouring of amniotic fluid, their absence at the time of opening of the cervix.
Restless behavior of a woman in labor.
Prolonged labor. The standards for primiparous are no more than 18 hours, if a woman is a repeat-parent, then the time is no more than 14 hours.
TREATMENT OF A NARROW PELVIS
The main task of a gynecologist who leads a pregnant woman with such a diagnosis is the timely installation of a narrow pelvis when its size does not correspond to the fetal head. In some cases, the best solution is a caesarean section to avoid negative consequences for the mother and child.
