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Chapter: Obstetric and Gynecological Nursing : Abnormal Labour

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Contracted Pelvis

Definition-When the one or more pelvic diameters arereduced by 1 centimeter or more centimeters.

Contracted Pelvis

Definition-When the one or more pelvic diameters arereduced by 1 centimeter or more centimeters.

 

Signs of contracted pelvis

 

·        In multigravida Prolonged and difficult labour with history of still births, instrumental delivery and neonatal deaths

·        In primigravida - pendulous abdomen

·        Woman is small - under 150 cm with short fingers and small feet

·        Bony deformity of spine , hip & leg

·        Pelvic assessment will reveal contracted pelvis

 

 

Degrees of contracted pelvis - Mild - Where the anterior parietal bone is at level withsymphysis pubis. 

 

Moderate - The head slightly overlaps at the edge of thepubis

 

Severe - The head bulges over the symphysis pubis

 

Methods of determining C.P.D.

 

·        Determining the degree of overlap by placing the fingers on the symphysis pubis while pressing the head down and with the other.

·        Head fitting - Sitting patient up method - patient lies on the bed. Place the patient to set up by her own effort. The effort should force the head into the pelvis and the midwife will feel its slip past her hand.

·        Head filling - left hand grip method - Grasp head with left hand and push it downward and backward if a sense of giveness felt there is no overlap or C.P.D.

 

Management

 

For mild and moderate C.P. D- Trial of labour is given Sever C.P. D. Cesarean section will be performed.

 

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