Maternal pelvis is small, fetal B-ultrasound is normal, can you try to give birth naturally?

Pelvic size will not only affect the process of natural delivery, but also dominate the delivery mode of expectant mothers; However, according to the rules of traditional mother-in-law, it is too general to judge the pelvic size by observing the female buttocks. The real judgment method should be based on professional medical equipment and internal diagnosis, so that the result will not be too far from the real pelvic size.

Case sharing: The fetal weight is also within the normal range for the items that were not examined in pelvic cavity before delivery in Ke Yu. However, in the process of natural delivery, she could not give full play to her strength, and the pelvic volume was suspected to be too small, so she changed to caesarean section temporarily and urgently, which is commonly known as "eating the whole meal", so that she had to bear the pain caused by two delivery methods in the future.

Part 1？ Conceptual article

Pelvic shapes are divided into four categories.

The pelvis of human and primate mammals is not exactly the same. According to the types, it can be simply summarized into four categories. The doctor said that the first type is the female pelvis, which is characterized by a round or oval shape; The second is the male pelvis, which has many edges and corners, which is somewhat similar to the shape of love; The third type is ape-shaped pelvis, which is characterized by wide front and back and narrow left and right; The last one is the flat pelvis, which is opposite to the ape-shaped pelvis, and is characterized by narrow front and back and wide left and right. Among these four types, female pelvis and ape-shaped pelvis are the most suitable for production.

The size of pelvis should not be judged by naked eyes.

"Oh, look at your ass, you must be good at having children in the future! I believe that up to now, there are still many women who have heard this sentence. Even if it is a joke between acquaintances, it shows that this practice has prevailed in traditional society for some time.

The doctor pointed out that judging the pelvic size is not according to the folk saying that "the buttocks are big or small from the back of women". On the contrary, it should be interpreted by modern scientific methods, such as X-ray irradiation or internal diagnosis, to diagnose the pelvic size of women.

Does pelvic size affect labor process?

Whether the pelvic size affects the labor process has been the focus of many mother-in-law since ancient times, and some even say that "a woman with a round ass should be born quickly"! In response to this problem, the doctor said that the factors affecting the progress of labor and the success of natural delivery can be roughly divided into four categories, namely, the size of the birth canal and pelvis, the size of the fetus, the uterine contractility and the force exerted by the expectant mother. So the size of the pelvis does affect the success of delivery. However, although this statement seems reasonable on the surface, it does not mean that a large pelvis must be born soon, and it must depend on the size of the fetus at that time and the health status of the expectant mother.

Part two? Measuring object

Pelvic x? Ray photography

Doctors pointed out that in order to measure whether the pelvic size can adapt to natural childbirth, doctors used pelvic X-ray photography in the past to help expectant mothers photograph the front and side of the pelvis respectively, so as to measure the symmetrical relationship between the fetal head size and the pelvis, and then classify it into narrow, medium or appropriate width. If it is in a narrow sense, the success rate of natural delivery is relatively low, and there is a chance to reach the standard of caesarean section.

However, expectant mothers have not yet entered the labor stage when they are exposed to X-rays. Once entering the labor stage, women will secrete relaxin, which will make the ligaments between bones softer, make the bones easy to separate, and contribute to the delivery of the fetus. In other words, even if the pelvis is small when X-rays are taken, it may swell during childbirth, so the accuracy rate is only 70%. Pelvic X-ray photography can not be used as the basis for caesarean section, and X-ray irradiation during pregnancy may lead to the risk of teratogenesis. In addition, whether the cervix is fully open and the fetal head is completely low during delivery is also an important key to affect the labor process, so fewer and fewer expectant mothers will do this examination now.

Manual internal diagnosis

Between 35 and 37 weeks of pregnancy, many doctors usually advise expectant mothers to screen for Streptococcus B to confirm whether there are bacteria in the birth canal. During the examination, a cotton swab will be used to take vaginal secretions from pregnant women. Some doctors will examine expectant mothers by the way and use their fingers to evaluate whether the angle between the left and right pubic bones is greater than 90 degrees. They will also measure the length of fetal head from vagina and the distance between the bone above pubic symphysis and fetal head. However, due to the different experience of each medical staff, the accuracy rate is not 100%, and even the evaluation results of different medical staff are quite different, which is only of reference value.

Part three? health supplies

Q 1？ How to help pelvic exercise?

In order to help the delivery process go smoothly, in addition to Rameze breathing, doctors suggest that sitting on a yoga ball or practicing breaststroke squatting is beneficial for the fetus to enter the pelvic cavity. In the late pregnancy, pelvic muscles are mainly trained, such as flywheel exercise and climbing stairs, especially climbing stairs can increase gravity and make the fetal head fall more easily, which will not be too heavy for pregnant women who are ready to give birth naturally.

Q2？ Why does the shape of pelvis change?

Even if it is a standard pelvic shape at ordinary times, it will still be affected in some cases, resulting in pelvic deformation.

If the correct sitting and standing posture is not cultivated in the bone development stage, resulting in scoliosis or hunchback, then the pelvic bone morphology will change; In addition, the pelvic cavity will also be damaged by external forces, such as falling, sitting on the ground, car accidents and so on. As long as the coccyx is pressed hard, the pelvis will be deformed, which will cause a burden on the natural delivery. Therefore, it is necessary to maintain the correct standing posture and sitting posture at ordinary times, and the way of exerting force during exercise should be determined, so as not to make the pelvis asymmetrical from left to right.

Q3？ Does childbirth deform or injure the pelvis?

You may have heard that some elders in the workshop will mention that the pelvis will get bigger or injured after giving birth, which makes some mothers who value their bodies very worried.

The doctor said that after childbirth, the pelvis will be injured more or less, because in the process of childbirth, in order to let the fetal head descend smoothly and send the fetus out of the body, the pubic bone will be separated by relaxin secreted by the body, which will cause special pain above the pubic hair. Some mothers can't even stand up after giving birth and have to rely on wheelchairs to get through this transition period. From a general point of view, it is also a kind of deformation; However, in theory, the pubic bone can be retracted to its original position after delivery.

Another example of injury is that the fetus accidentally hurt the mother's coccyx when passing through the pelvic cavity. The doctor pointed out: "In the process of evolution, human beings gradually abandoned their tails. Although the coccyx is not as long as orangutans and apes, it does not mean that it has completely disappeared. Some mothers are accidentally pressed into the caudal vertebra by the fetus during childbirth, and even cause the caudal vertebra to break, so they will feel pain after childbirth, especially when sitting in a chair. If they find this symptom after delivery, they should ask a doctor to take an X-ray to confirm whether the coccygeal vertebra is broken, and some people can heal themselves. In severe cases, they may need to seek the help of an orthopedic surgeon, even without excluding surgery. 」

In addition, when the fetal head passes through the birth canal, it will lead to vaginal relaxation and bladder prolapse. Broadly speaking, these symptoms can also be called pelvic deformation, because both vagina and bladder belong to the soft tissue in the pelvic cavity.

Q4？ What sequela can there be when the pelvis is too small during delivery?

During normal delivery, if the expectant mother's pelvic cavity is smaller than the fetal head, it may delay the labor process and lead to fetal breathing difficulties. In the process of fetal head passing through pelvic cavity and birth canal, the head will be pointed and edema symptoms will appear, but usually it will improve itself within seven days; Hematoma should be paid more attention to. Although the fetus can absorb blood clots by itself, it may have a negative impact on future brain development.