CLINICAL PELVIMETRY

Usually done after 38 weeks or in labor

Prerequisite : empty the bladder

Pelvic assessment

Look for CPD

Bishop score

Decide whether
patient able to do
vaginal delivery or
not
 1. PELVIC ASSESMENT

Assess inlet, cavity and outlet – if any inadequate  contracted pelvis  absolute CSEC

Inlet Cavity Outlet

Transverse diameter > AP Assess AP diameter > transverse
diameter  Sacrum curvature Assess
 Lateral wall of pelvis  Subpubic arch –
Inlet has – straight , admit two finger
 Anatomical divergence ,  Subpubic angle –
coniugate – between convergence obtuse ( index and
promontory of  Ischial spines – thumb ) / acute
sacrum and superior interspinous ( index and middle
margin of the diameter  if can finger )
symphysis pubis feel both spine in  Ischial tuberosity –
(11cm) pronated hand  admit 4 knuckles
 Diagonal conjugate – pelvic inadequate
between sacral
promontory and If the wall of pelvis is
symphysis pubis convergence  pelvic
( 10.5cm ) inadequate
 Obstetrics conjugate
– between sacral
promontory and
inferior margin of
symphysis pubis
(12cm)

Inference : pelvic is
adequate if we cannot feel
promontory
 2. ASSESMENT OF CPD

Relative indication of CSEC

Mild CPD – allow for vaginal delivery

 Left hand push head of baby

 Note whether the ehad touch the middle finger at the level of ischial spine

Mild CPD

 Not touching the internal finger / not reaching the ischial spine

Severe CPD

 Thumb get pushed by the head of baby  absolute indication of CSEC

3. BISHOP SCORE
FAVORABLE if score > 6