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, which results from kyphosis (hunchback) of the spine.
The defining feature is the forward projection of the lumbar vertebrae and sacrum into the pelvic cavity.
This creates a funnel-shaped pelvis, where the inlet may be roomy, but the outlet is severely contracted.
During labor, this leads to deep transverse arrest or obstruction at the pelvic outlet, as the fetal head cannot pass the narrowed space.

Option B: An Osteomalacic pelvis, caused by bone softening from vitamin D deficiency, has a characteristic triradiate or heart-shaped brim due to the inward pushing of the acetabula and sacral promontory. The image does not show this shape.
Option C: A Naegele's pelvis is an obliquely contracted pelvis resulting from the arrested development of one sacral ala. This creates a marked asymmetry, which is not the primary feature seen in the image.
Option D: A Robert's pelvis is a rare, transversely contracted pelvis caused by the absence of both sacral alae. This results in a very narrow, almost triangular pelvic inlet. The image shows a forward projection of the spine, not a primary transverse contraction.

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.
Identifying a kyphotic pelvis is critical for antenatal planning, as it almost always indicates the need for a planned cesarean section.
Attempting a vaginal delivery with a kyphotic pelvis carries a high risk of obstructed labor at the outlet, leading to fetal distress, uterine rupture, and severe maternal trauma.
A nurse assessing a pregnant woman with a history of spinal deformity like kyphosis should anticipate potential cephalopelvic disproportion and ensure the healthcare team is prepared for a surgical delivery.

How to Approach the Question

First, carefully examine the image to identify the primary anatomical abnormality. Notice the severe forward and downward displacement of the lower spine into the pelvic space.
Relate this spinal deformity to the overall shape of the pelvis. Observe that this creates a funnel effect, narrowing the pelvis from top to bottom.
Recall the definitions of different types of abnormal pelves.
Match the observed features (spinal projection, funnel shape, outlet contraction) to the correct definition. The forward spinal curve is the hallmark of kyphosis, leading to a Kyphotic pelvis.
Eliminate the other options by comparing their defining characteristics (triradiate brim for Osteomalacic, unilateral contraction for Naegele's, bilateral transverse contraction for Robert's) with the image.

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: Image shows a pelvis with a pronounced forward curvature of the lumbar spine.

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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