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Narrow hip bone can prevent normal birth?

Narrow hip bone can prevent normal birth?

From the obstetric point of view, the knowledge of the bony pelvis (PO), also called the bone or hip basin is indispensable, since it is through it that the fetus passes to be born during childbirth. It consists of four bones: the two iliac bones, the sacrum and the coccyx. These four bones form a "ring" called the pelvic girdle and have two planes: superior or large pelvis (also called "false pelvis") and the lower or small pelvis (also called "true pelvis"). It has an upper or "narrow upper" opening, below the large pelvis and the "lower narrow" that communicates with the outside. Between the two lies the middle portion: the pelvic cavity, which is of major importance for the mechanism of passage of the fetus during labor.

The passage of the baby will depend on the compatibility between the various bone diameters and the diameters of the fetal presentation, more often, of the cephalic presentation (fetal head). The bony pelvis is supplemented by muscles, tendons and ligaments - called "soft parts" - that give them both internal and external conformation. Its form is varied and depends on the constitutional characteristics of each woman.

They are classics four basic or pure types: gynecoid, android, anthropoid and platipelid. There are important differences between the male pelvis and the female pelvis, either in the bone constitution, or in the shape as to the dimensions of the axes and diameters. Certain basins of the woman present masculine or atypical characteristics, which may hinder or even prevent a normal birth, by the natural route. In addition to the "pure types" of the basin there are the "mixed" whose conformation is the result of the association of characteristics of various dimensions both in shape and diameter, leading to important individual differences that influence, facilitating or hindering the evolution of delivery mechanisms. In general, it is in the middle narrow of the basin that the "difficulties" in adapting or rotating the fetal parts (head or baby's basin) occur.

Simple assessment of a pregnant woman's hip by an experienced obstetrician can "suggest" if the basin is "good" for a vaginal delivery. In certain specific and rarer situations, such as malformations and fractures, we may in advance use radiological resources to evaluate certain parts of the basin that may interfere with the evolution of the delivery mechanisms.

The most important, undoubtedly, is clinical evaluation of some basin diameters, made through the genital touch, which allows to suspect if the fetal head will be able to transpose certain levels of the basin (fetal disproportion). Often the head does not hint at the size of the fetus, its position or other, leading to the indication of a cesarean section.

If the woman is experiencing labor dynamics without accompanying fetal head insinuation ( cephalopelvic dystonia), we have to be attentive and open to indicate cesarean section. The well-conducted vaginal touch, especially evaluating the anteroposterior (pubis and sacrum) diameter and some bony projections within the pelvis, is what diagnoses and defines whether the attempt for normal delivery should be continued without exposing the baby to the " fetal distress "and the parturient, the" maternal scam. "


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