A&P- types of pelvis
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Transcript of A&P- types of pelvis
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JENIS JENIS PELVIS
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TERDAPAT 4 JENIS PELVIS
• Gynaecoid
• Android
• Platypelloid
• anthropoid
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JENIS JENIS PELVIS
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LANDMARK PERBEZAAN
• Brim
• Forepelvis
• Side walls
• ischial spine
• Sciatic notch
• Subpubic angle
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GYNAECOID PELVIS
• Brim – bulat( rounded ) • Fore pelvis – luas• Sidewalls – straight• Ischial spine – blunt• Sciatic notch – bulat• Sacrum – well curve dan luas ( cavity )• Sub pubic angle – 90 darjah• Cavity - shallow• Normal pelvis wanita dan boleh melahirkan
secara normal
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GYNAECOID
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ANDROID PELVIS( pelvic lelaki )
• Brim – bentuk hati• Forepelvis – sempit• Sidewalls – convergent• Ischial spine – menonjol ( prominant ) kedalam• Sciatic cotch – sempit• Sacrum – straight- panjang dan cavity panjang• Cavity – dalam disebabkan sidewall converge
berbentuk funnel• Subpubic angle – kurang dari 90 darjah
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• Implikasi pada kelahiran :-
- Outlet pubic arch sempit dan kepala tidak muat ( fit )
- Ischial spine – prominence menyukarkan untuk internal rotation secara complete dan anterior posterior diameter akan tersekat menyebabkan deep transverse arrest
- Subpubic arch tidak sesuai ( sempit ) untuk biparietal dan akan tertolak kebelakang
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• Implikasi pada kelahiran :-
- Position janin biasanya dalam posisi occipito-posterior
- Brim bentuk heart sempit dianterior dan luas diposterior untuk biparietal diameter. Janin selesa untuk diposterior
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ANDROID
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PLATYPELLOID
• Pelvic brim - Berbentuk kidney. Anterior posrterior diameter pendek, transverse diameter panjang
• Forepelvis – luas• Sidewalls – divergent• Ischial spine – blunt• Sciatic notch- luas• Sacrum- straight• Cavity- shallow ( cetek ) terdpat ruang untuk
fetal head• Subpubic angle – melebihi 90 darjah
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• Implikasi pada kelahiran- dengan uterIne contraction yang baik Akan tertolak kecavity dan moulding
berlaku disebabkan tekanan proses dinamakan asynclinism
- Bertambah transverse diameter dan berkurangan anterior posterior diameter kepala akan descend dengan baik .
- Engagement akan berlaku kepala akan tilted untuk menyesuaikan dengan anterior posterior diameter yang sempit
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- Biparietal diameter akan tersekat di sacrocotyloid diameter pelvic brim dan uterine contraction menyebabkan kepala extend sambil descend ( normal flexion berlaku semasa kepala descend )- face presentation
- Jika contracted yang teruk - LSCS
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PLATYPELLOID
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ANTHROPOID
• Brim – panjang dan oval• Forepelvis- sempit• Sidewalls – divergent• Ischial spine – blunt• Sciatic notch – luas• Subpubic angle – melebihi 90 darjah• Sacrum – panjang • Cavity – dalam dan concave
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• Implikasi pada kelahiran
- Boleh melahirkan dengan normal - Janin dalam direct occipito posterior or
occipito anterior position- Present long diameter of head in
anterioposterior diameter brim- Occiput di hollow of sacrum , fetus melalui
pelvis dalam posisi yang sama dan lahir dalam unreduced occipito posterior position
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ANTHROPOID
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BENTUK PELVIS
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SUBOUBIC ARCH
SCIATIC NOTCH
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ASYNCLITISM
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ASYNCLITISM
ANTERIOR ASYNCLITISM
Anterior parietal bone bergerak kebawah dibelakang symphysis pubis sehingga parietal eminence memasuki brim
Pergerakan in akan terbalik kepala tilt dalam arah yang berbeza sehingga cuba melintasi sacral promontory dan kepala engageposterior parietal bone
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POSTERIOR ASYNCLITISM
pergerakan anterior asynclinism tebalik .
Posterior parietal cuba melintasi sacral promotory sebelum anterior parietal bone bergerak kebawah belakang symphysis pubis