THE PELVIS

IREEN CHISHIMBA
2ND YEAR BNMWsc
The pelvis girdle
The pelvic girdle is a basin shaped cavity, a bony ring between the moveable vertrae of the
vertebral column which it supports, and the lower limbs that it rests on. It contains and protects
the bladder, rectum and internal reproductive organs.

Functions
The primary function of the pelvic girdle is to allow movement of the body, especially walking
and running. This makes it necessary for the sacroiliac joint to be immensely strong and
virtually immobile. The pelvis also takes the weight of the sitting body onto the ischial
tuberosities.
Bones of the pelvis
The pelvic girdle, which is stronger and more massively constructed than the wall of the cranial
or thoracic cavities is composed of four bones; Two innominate laterally and anteriorly, the
sacrum and coccyx posteriorly.
Innominate bones
Each innominate bone is made up of three bones that have been fused together
 Ilium
 Ischium
 Pubis
The ilium
This is the large flared out part. When the hand is placed on the hip, it rests on the illiac crest,
which is the upper boarder. At the front of the iliac crest can be felt a bony prominence known
as the anterior superior iliac spine. A short distance below it is the inferior iliac spine. There are
two similar points at the other end of the iliac crest, namely the posterior superior and the
posterior inferior iliac spines. The concave anterior surface of the ilium is the iliac fossa.
The Ischium
This is the thick lower part, it has a large prominence known as the ischial tuberosity, on which
the body rests when sitting. Behind and a little above the tuberosity is an inward projection
called the ischial spine. In labour the station of the fetal head is estimated in relation to the
ischial spines.
The Pubis
This forms the anterior part. It has a body and two oar like projections, the superior ramus and
the anterior ramus. The two pubic bones meet at the symphysis pubis and the two inferior Rami
form the pubic arch, merging into a similar ramus on the Ischium. The space enclosed by the
body of the pubic bone, the Rami and the Ischium is called the obturator foramen.
The innominate bone contains a deep cup to receive the head of the femur called the
acetabulum, which is composed of the three fused bones in the following proportions: two fifth
ilium, two fifths Ischium and one fifth pubis.
On the boarder of the innominate bone are two curves. One curve extends from the posterior
inferior iliac spine UpTo the ischial spine and its called the Greater sciatic notch.
CONT.
 It is wide and rounded.

The other curve lies between the ischial spine and the ischial tuberosity and is known as the
lesser sciatic notch.
The Sacrum
The sacrum is a wedge shaped bone consisting of five fused vertebrae. The upper boarder of the
first sacral vertebra, which juts forward is known as the sacral promontory. The anterior surface
of the sacrum is concave and is referred to as the hollow of the sacrum. Laterally the sacrum
extends into a wing of ala. Four pairs of holes or foramina pierce the sacrum and through these
holes nerves from the cauda equina emerge to supply the pelvic organs. The posterior surface is
roughened to receive attachments of the muscles.
The coccyx
The coccyx is a vestigial tail. It consists of four vertebrae forming small triangular bone, which
articulates with the fifth sacral segment.
Pelvic Joints
There are four pelvic Joints: one symphysis pubis, two sacroiliac joints and one sacrococcygeal
joint.
The symphysis pubis is the midline cartilaginous joint uniting the Rami of the left and right
pubic bones.
The sacroiliac joints are strong, weight bearing synovial joints with irregular elevations and
depressions that produce interlocking of the bones. They join the sacrum to the ilium and as a
result connect the spine to the pelvis. The joints allow a limited backward and forward
movement of the tip of the promontory of the sacrum known as nodding.
The sacrococcygeal joint is formed where the base of the coccyx articulates with the tip of the
sacrum. It permits the coccyx to be deflected backwards during birth of the fetal head.
THE TYPES OF PELVIS
The type or size of the pelvis varies not only in the two sexes but also in different members of
the same sex. The height of the individual does not appear to influence the size of the pelvis in
any way as women of short stature in general have a broad pelvis. Nevertheless, the pelvis is
occasionally equally contracted in all dimensions, so much so that all diameters can measure
1.25cm less than average. This type of pelvis is known as a Justo minor pelvis. The principal
differences however, are found at the brim and affect the relation of the anterior posterior to the
transverse diameter. If one measurement is reduced by 1cm or more from normal the pelvis is
said to be contacted and may give rise to difficulty in labour or necessitate ceasarean section.
Classically, pelves have been described as failing into four categories namely; Gynaecoid Pelvis,
Android pelvis also known as male pelvis, the anthropoid pelvis and the platypelloid pelvis
TYPES OF PELVIS CONTI…….
The Gynaecoid Pelvis
This is the best type for child bearing as it has a rounded brim, generous forepelvis straight side
walls, a shallow cavity with a well curved sacrum and a sub pubic arch of 90°.
The Android pelvis
The Android pelvis is also called the male pelvis. It’s brim is heart shaped, it has a narrow
forepelvis and it’s transverse diameter is situated towards the back. The side walls converge
making it funnel shaped and it has a deep cavity and a straight sacrum. The ischial spines are
prominent and the sciatic notch is narrow. The sub pubic arch is less than 90°. It is found in
short and heavily built women who have a tendency to be hirsute (Hairly).
TYPES OF PELVIS CONTI……
The Anthropoid pelvis
This type has a long oval brim in which the anterior posterior diameter is longer than the
transverse diameter. The side walls diverge and the sacrum is long and deeply concave. The
ischial spines are not prominent and the sciatic notch and the sub pubic angle are very wide.
Women with this type of pelvis tend to be tall with narrow shoulders. Labour does not usually
present any difficulties, but a direct occipital posterior position is often a feature and the position
adopted for engagement may persist birth.
The platypelloid pelvis
This pelvis is flat and has a kidney shaped brim in which the anterior posterior diameter is
reduced and the transverse diameter increased. The sacrum is flat and the cavity shallow. The
ischial spines are blunt and the sciatic notch aswel as sub pubic arch are both wide.
PELVIC DIAMETERS
Knowledge of the diameters of the normal female pelvis is essential in the practice of midwifery
because contraction of any of them can result in malposition or malpresentation of the
presenting part of the fetus.
Diameters of the brim
The brim has three principal diameters, the transverse diameter, the oblique diameter and the
anterior posterior diameter.