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Bony pelvis and fetal skull Dr Malleswar Rao K

Bony pelvis and fetal skull Dr Malleswar Rao K. Objects. Fetal head Pelvic anatomy Pelvic shapes. Passenger. Fetal head. Landmarks Sutures Fontanelles Diameters. Fetal head. From an obstetrical point of view it ’ s the most important part: largest

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Bony pelvis and fetal skull Dr Malleswar Rao K

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  1. Bony pelvis and fetal skull Dr Malleswar Rao K

  2. Objects • Fetal head • Pelvic anatomy • Pelvic shapes

  3. Passenger

  4. Fetal head • Landmarks • Sutures • Fontanelles • Diameters

  5. Fetal head From an obstetrical point of view it’s the most important part: • largest • least compressible part of the fetus. • most frequent presenting part

  6. Landmarks • Head is divided into 3areas • (1) the sinciput or brow portion; • (2) the vertex, or top of the head between the 2 fontanelles; • (3) Base large, ossified, firmly united, and noncompressible

  7. Sutures • Membrane-occupied spaces between the cranial bones 1-Sagittal suture: - lies btw the parietal bones -extends in an AP direction btw the fontanelles -divides the head into right and left sides

  8. 2-lambdoid suture: • extends from the posterior fontanelle laterally • separate the occipital from the parietal bones.

  9. 3-coronal suture: • extends from the anterior fontanelle laterally • separate the parietal and frontal bones.

  10. 4- frontal suture: • lies between the frontal bones • extends from the anterior fontanelle to the glabella (the prominence between the eyebrows).

  11. Clinical importance of sutures • Position of fontanelle & sagittal suture can identify attitude and position of vertex. • By plapating the sagittal suture during labour, degree of internal rotation & molding of the head can be noticed. • In deep transverse arrest, this sagittal suture lies transversely at the level of the ischial spines.

  12. Moulding… Reshaping of the fetal skull: Obliteration of the sutures. Overlapping of the bones of the vault: One parietal bone overlaps the other. Both overlap the occipital bone. It accounts for diminution of the biparietal diameter and suboccipitobregmatic diameters by 0.5-1 cm. 0r even more.

  13. A: Well flexed Head • B: Partially Flexed Head • C: Deflexed Head • D: Face Presentation • E: Brow presentation

  14. The anterior fontanelle (bregma) : • diamond shaped area(2 × 3 cm) of unossified membrane formed by the junction of 4 suture.

  15. The posterior fontanelle: • It is the triangular depressed area at the junction of 3 suture: • closes at 6 to 8 weeks of life • Y- or T-shaped

  16. ROT LOT

  17. LOA ROA

  18. LOP ROP LOP

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