Female Pelvic Bones

The female pelvis is structurally adapted for child bearing and delivery.
There are four pelvic bones
- innominate or hip bones
- Sacrum
- Coccyx

A. Innominate bones
Each innominate bone is composed of three parts.
1. The ilium the large flared out part
2. The ischium the thick lower part. It has a large prominance known as the ischial tuberosity on which the body rests when sitting. Behind and a little above the tuberosity is an inward projection, the ischial spine. In labour the station of the fetal head is estimated in relation to ischial spines.
3. The pubis - The pubic bone forms the anterior part. The space enclosed by the body of the pubic bone the rami and the ischium is called the obturator foramen.

B. The sacrum - awedge shaped bone consisting of five fused vertebrae. The upper border of the first sacral vertebra is known as the sacral promontary. The anterior surface of the sacrum is concave and is referred to as the hallow of the sacrum.

C. The coccyx: - is avestigial tail. It consists of four fused vertebrae forming a small triangular bone.

Pelvic Joints
There are four pelvic joints
- One Symphysis pubis
- Two Sacro illiac joint
- One Sacro coccygeal joint
- The symphysis pubis is a cartilgeous joint formed by junction of the two pubic bones along the midline.
􀂃 The sacro iliac joints are the strongest joints in the body.
- The sacro coccygeal joint is formed where the base of the coccyx articulates with the tip of the sacrum.

In non pregnant state there is very little movement in these joints but during pregnancy endocrine activity causes theligaments to soften which allows the joints to give & provide more room for the fetal head as it passes through the pelvis.

Pelvic ligaments
Each of the pelvic joints is held together by ligaments
- Interpubic ligaments at the symphysis pubis (1)
- Sacro iliac ligaments (2)
- Sacro coccygeal ligaments (1)
- Sacro tuberous ligament (2)

- Sacro spinous ligament (2)

The True Pelvis
The true pelvis is the bony canal through which the fetus must pass during birth. It has a brim, mid cavity and an out let. The pelvic brim is rounded except where the sacral promontory projects into it. The pelvic cavity is extends from the brim above to the out let below. The pelvic out let are two and described as the anatomical and the obstetrical. The anatomical out let is formed by the lower borders of each of the bones together with the sacrotuberous ligament. It is diamond in shape. The obstretrical out let is of the space between the narrow pelvic strait and the anatomical outlet.

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Importance of Obstetrics and Gynecology nursing

Ensuring healthy antenatal period followed by a safe normal delivery with a healthy child and an uneventful post partum period. Prompt and efficient cares during obstetrical emergencies also prevent so many of complications. The importance of the obstetric and gynecology nursing are:

• Equip the nurse with the knowledge and understanding of the Anatomy and physiology of reproductive organ be able to apply it in practice
• With a good knowledge of obstetric drugs including, the effect of diseases their Complications and know how to deal with them.
• Develop skills in carrying out antenatal care and be able to detect any abnormality, recognize and prevent complications.
• Select high risk cases for hospital delivery and provide health education.
• Develop skills in supporting the women in labour, maintain proper records, and deliver her safely and resuscitate her new born when necessary.
• Be able to care for the mother and baby during the post partum period and be able to identify abnormalities and help them to get-over it.
• Be able to educate them on care of the baby, immunization, family guidance and family spacing.
• Be ready to offer advice to support the mother and understand her problems as a mature, kind and helpful nurse.

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