NORCET 3 - 2022 (Shif…: Identify the following type of abnormal pelvis?

NORCET 3 - 2022 (Shift-1)

Obstetrics & Gynaecology

Medium

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

The image shows a kyphotic pelvis, characterized by the forward projection of the lumbar spine and sacrum into the pelvic cavity.
This deformity creates a funnel shape, where the pelvic inlet's anteroposterior diameter is increased, but the pelvic outlet is severely contracted.
This condition is a direct result of kyphosis (hunchback) of the spine, which alters the pelvic architecture.
During labor, this can cause the fetal head to become arrested at the outlet, despite engaging easily in the inlet.

Option B: An osteomalacic pelvis, caused by bone softening from conditions like rickets, results in a triradiate or heart-shaped pelvic brim due to the inward pressure on the acetabula and sacrum. The image does not show this characteristic shape.
Option C: Naegele's pelvis is an obliquely contracted pelvis caused by the congenital absence or underdevelopment of one sacral ala. This results in a distinctly asymmetrical pelvic inlet, which is not the feature shown in the image.
Option D: Robert's pelvis is a rare and severe deformity characterized by the absence of both sacral alae. This leads to extreme transverse contraction of the pelvis, making the brim appear almost triangular. The image shows a funnel shape, not a transversely contracted one.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of abnormal pelvic types based on anatomical deformities as background academic context rather than a clinical decision trigger.
Recognizing a kyphotic pelvis is critical for antenatal planning. It is a major cause of obstructed labor at the pelvic outlet.
A nurse assisting in labor should be aware that with a kyphotic pelvis, good progress in the first stage of labor can be misleading, as the real challenge occurs at the outlet.
What if? If the fetus was small for gestational age, vaginal delivery might be possible despite the contracted outlet. However, with an average or large-sized fetus, an elective or emergency cesarean section is the most likely and safest mode of delivery.

How to Approach the Question

First, carefully examine the image to identify the primary anatomical abnormality. Notice the severe forward curvature of the lower spine into the pelvic space.
Relate this spinal deformity to its effect on the pelvic structure. The forward projection of the sacrum creates a funnel shape, widening the inlet's front-to-back dimension while narrowing the outlet.
Recall the definitions of different types of abnormal pelves. A kyphotic pelvis is specifically defined by this funnel shape caused by spinal kyphosis.
Compare the observed features with the characteristics of the other options. Rule out Naegele's (asymmetry), Robert's (transverse contraction), and Osteomalacic (triradiate brim) as they do not match the visual evidence.
Select the option that directly corresponds to the identified deformity.

Concept Tested & Keywords

Concept Tested: Identification of abnormal pelvic types based on anatomical deformities.
Stem keywords: abnormal pelvis, identify
Lead-in keywords: Identify
Clinical cues: The image shows a pronounced forward curvature of the lumbar spine projecting into the pelvic inlet, which is the defining feature of a kyphotic pelvis.

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 50-60

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 2060-2062