(2018) Maternal and Child Health Nursing, 8th
Pilliteri, Adele and Silbert-Flagg, JoAnne Edition. USA: Lippincott Williams and Wilkins
LESSON REVIEW/PREVIEW (5 minutes)
MAIN LESSON (45 minutes)
Please refer to Chapter 15: The Nursing Care of a Family During Labor and Birth-The Components of Labor-The Passage
p. 328
I. COMPONENTS OF LABOR
5 P’s:
1. PELVIS (the PASSAGE)
2. FETUS (the PASSENGER)
3. Uterine factors (POWERS of labor)
4. a woman’s PSYCHE
5. POSITION
If the 5 Components:
(1) the woman’s PELVIS (the passage ) is of adequate size & contour
(2) the FETUS (the passenger) is of appropriate size & in an advantageous position & presentation
(3) the uterine factors (powers of labor) are adequate
(4) her (Position) is comfortable and facilitates the labor process
(5) the woman’s PSYCHE is preserved so that afterward, labor can be viewed as a positive
experience
A. PASSAGEWAY or PASSAGE (PELVIS) 2 Divisions of the Pelvis:
Refers to the route a fetus must travel FALSE PELVIS- upper half which supports
from the uterus through the cervix & the uterus during the late months of
vagina to the external perineum pregnancy & aids in directing the fetus
It is the mother’s bony pelvis and soft into the true pelvis for birth
tissues of the cervix, pelvic floor, vagina
and introitus TRUE PELVIS- lower half of the pelvis;
long, bony, curved canal divided into 3
Functions parts:
Support & protect the reproductive o inlet,
& other pelvic organs o pelvic cavity
Accommodation of the growing fetus o outlet
Anchorage of the pelvic support
structures
Composition
Anterior & lateral portion made up LINEA TERMINALIS or BRIM- imaginary line
of 2 innominate hip bones divided from the sacral promontory to the superior
into 3 parts (ilium, ischium and border of the SP which divides the pelvis
pubis into true & false pelves
Posterior portion: sacrum, coccyx
1. Types of Female Pelvic Shapes c. Anthropoid- “APE-LIKE”
a. Gynecoid Pelvis “FEMALE” It’s transverse diameter is narrow; the
Has an inlet that is well-rounded and has a anteroposterior diameter of the inlet is larger
wide pubic arch than usual.
Ideal for childbirth Even though the inlet is large, the shape of
the pelvis does not accommodate a fetal
b. Android- “MALE” head as well as the gynecoid pelvis
The pubic arch forms an acute angle, making
the lower dimensions of the pelvis extremely d. Platypelloid – “Flattened” (oval)
narrow It has a smoothly-curved oval inlet, but
A fetus may have difficulty exiting from this the anteroposterior diameter is
type of pelvis shallow.
A fetal head might not be able to rotate to
match the curves of the pelvic cavity
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2. ESTIMATING PELVIC SIZE (PELVIMETRY)
2 important pelvic measurements to determine the adequacy of the pelvic size:
• the DIAGONAL CONJUGATE (anterior-posterior diameter of the inlet)
• the TUBERO-ISCHIAL or BI-ISCHIAL DIAMETER (transverse diameter of the outlet)
DC (Diagonal conjugate) is the narrowest diameter of the inlet & the (TD) Tubero-ischial
Diameter is the narrowest diameter of the outlet (11.5 cm)
TD of pelvic cavity/inter-spinous diameter= 10 cm
TD of outlet/bi-ischial diameter= 11.5
Anteroposterior Measurements of the Inlet Measurement of the Transverse Diameter of the Outlet
a. TUBERO-ISCHIAL or BI-ISCHIAL Diameter of
the Outlet
a. DIAGONAL CONJUGATE= 10.5 - 11 cm. It is the distance between the ischial
o It is the measurement between the tuberosities, or the transverse diameter of
anterior surface of the sacral the outlet (the narrowest diameter at that
prominence (sacral promontory) level, ot the one most apt to cause a
and the posterior surface (inferior misfit)
margin) of the symphysis pubis It is made at the medial and lowermost
o measured by internal aspect of the ischial tuberosities, at the
examination; AP diameter level of the anus
Diameter of 11 cm is considered
b. OBSTETRIC CONJUGATE= > 10 cm. adequate because it will allow the
widest diameter of the fetal head, or 9
o It is the distance between the cm, to pass freely through the outlet
midpoint of the sacral promontory
& the midline of the symphysis
pubis which is ascertained by
subtracting 1 to 1.5 cm from the
diagonal conjugate
o OC= DC – 1 to 1.5
c. TRUE CONJUGATE/CONJUGATA VERA= > 11 cm.
o It is the distance between the midpoint of
the sacral promontory and the upper or
superior margin of the symphysis
pubis
This document and the information thereon is the property of PHINMA
Education (Department of Nursing) 3 of 7
This document and the information thereon is the property of PHINMA
Education (Department of Nursing) 4 of 7
