General survey pregnant

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The rate of change of the angle of inclination of the pelvis and lumbar lordosis for various positions of the body characterize the degree of mobility of sacroiliac joint and lumbar spine.
From here it is possible to make known the view about changes to the true conjugates, and thus to judge about the possibility of insertion and promote the head of the fruit through the bone ring.
Thus, in the measurement of Taza obstetrician must necessarily take into account the value of the inclination of the pelvis and be able to correct, especially when gray and clinically narrow basins in some moments of the descent act, with the aim of creating the most favorable conditions for promotion of the fetus through the birth canal.
So, for correction dramatically saddetelinara insertion (Litmanovich) inclination angle of the pelvis should be reduced, and if prednamerennoe (Negulesco), on the contrary, it is necessary to increase (S. Ya. Malinovskaya and others).
In Fig. 5 it is shown that if in promontorium draw a line parallel to the line passing through the symphysis, and then be omitted from promontorium perpendicular to it and at the same time, from the point of symphysis draw a line parallel to it, it turns out quadrangle.
Last splits the line into two triangles, the corners of it as equal to each other.
When changing body position surveyed women, namely when it from the vertical to the horizontal (see Fig. 5) the inclination angle of the basin is formed by the intersection of the direct size of the entrance into the bowl with a vertical line. Thus the value of the inclination angle of the pelvis remains the same.
However, in case of horizontal position of the body inclination angle of the pelvis may vary depending on the location of the lower extremities (see Fig. 5), and when lifting the upper body (the so-called feverously position) (see tab. 1).
Recommending to the lying to accept a position of a body depending on the specifics of each case, you can change the size of the true conjugates. So, for correction dramatically saddetelinara inserting head inclination angle of the pelvis be reduced. With this purpose it is necessary to put a cushion under the sacrum (see Fig. 6, a).


Fig. 5. Schematic illustration of the changes of inclination angle of the pelvis standing up and lying down.
and in the standing position; b - in the supine position; - for each position of the symphysis; 1 - plane entrance to the pelvis; 2 - outer conjugate; 3 - horizontal plane (in a standing position).

Fig. 6. The use of strikes when syncleticea ustawieniach head.
b - when predatelem the insertion of the strikes is placed under the lower back, which increases the inclination angle and promotes prednamerennoe bones; and - with aadditional the insertion of the strikes is placed under the sacrum, which reduces the inclination angle and promotes zaznamenal bones.

In the presence dramatically prednamerennoe the insertion, on the contrary, the inclination angle of the pelvis should be increased. To this end the strikes placed under the waist (see Fig. 6, b). In those cases, when there is a need, Vice versa, or even eliminate prednamerennoe inserting, or to reduce the degree of insertion, it is necessary to reduce the inclination angle of the pelvis so that the resultant of the progressive forces on the centerline of the pelvis; this creates the most favorable conditions for inserting head in the entrance to the pelvis.
In accordance with that recommended in pregnant women during the period of the opening, when the mobile head and the presence of a large inclination angle of the pelvis to lift your upper body. Such a position of the body is achieved by reduction of inclination angle of the pelvis.