n. (pl. pelves) 1. the bony structure formed by the *hip bones, *sacrum, and *coccyx: the bony pelvis (see illustration overleaf). The hip bones are fused at the back to the sacrum to form a rigid structure that protects the organs of the lower abdomen and provides attachment for the bones and muscles of the lower limbs. The female pelvis may be one of four shapes (see illustration overleaf). In the android pelvis the cavity is funnel-shaped with a contracted outlet; the anthropoid pelvis is long, narrow, and oval. The classical shape, gynaecoid, has a transversely oval outlet and a roomy pelvic cavity; the platypelloid pelvis is wide and flattened at the brim, with the promontory of the sacrum pushed forward. 2. the lower part of the abdomen. 3. the cavity within the bony pelvis. 4. any structure shaped like a basin, e.g. the expanded part of the ureter in the kidney (renal pelvis). —pelvic adj.... pelvis
n. surgical treatment of *vault prolapse, which can be an abdominal or laparoscopic procedure. It involves suspending the prolapsed vaginal vault to the sacral promontory using a synthetic mesh or biological material; however, it is associated with a significant risk of haemorrhage and mesh erosion. Posterior intravaginal slingplasty (or infracoccygeal sacropexy) is a more recent technique in which a neo-uterosacral ligament (which supports the vagina) is formed. This helps to relocate the vaginal apex and restore the normal vaginal axis. The procedure appears to have similar efficacy to those currently in use but with minimal surgical morbidity.... sacrocolpopexy
a difficult birth (see dystocia) in which the anterior or, less commonly, the posterior fetal shoulder impacts on the maternal symphysis or sacral promontory. It is an obstetric emergency and is diagnosed when the shoulders fail to deliver after the fetal head and when gentle downward traction has failed. Additional obstetric manoeuvres (e.g. *McRobert’s manoeuvre) are required to release the shoulders from below the pubic symphysis. It occurs in approximately 1% of vaginal births. There are well-recognized risk factors, such as maternal diabetes and obesity and fetal *macrosomia. There can be a high *perinatal mortality rate and morbidity associated with the condition; the most common fetal injuries are to the brachial plexus, causing an *Erb’s palsy or *Klumpke’s paralysis. Maternal morbidity is also increased, particularly *postpartum haemorrhage.... shoulder dystocia
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