A narrow pelvic outlet increases the risk for emergency cesarean section

Stålberg, Karin; Bodestedt, Åke; Lyrenäs, Sven; Axelssön, Ove

doi:10.1080/00016340600593521

Cited by 29 publications

(33 citation statements)

References 25 publications

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“…This does not occur in males. It has been reported that the sacral inclination has an important effect on lower pelvic capacity during childbirth (44,45) and that women who required an emergency Cesarean section had a more narrow pelvic outlet (i.e., an inward-projecting sacrum) than a control group (47).…”

Section: Fig 2 Sexual Dimorphism In the Human Pelvis (A)mentioning

confidence: 99%

Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma

Fischer

Mitterœcker

2015

Proc. Natl. Acad. Sci. U.S.A.

105

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Compared with other primates, childbirth is remarkably difficult in humans because the head of a human neonate is large relative to the birth-relevant dimensions of the maternal pelvis. It seems puzzling that females have not evolved wider pelvises despite the high maternal mortality and morbidity risk connected to childbirth. Despite this seeming lack of change in average pelvic morphology, we show that humans have evolved a complex link between pelvis shape, stature, and head circumference that was not recognized before. The identified covariance patterns contribute to ameliorate the "obstetric dilemma." Females with a large head, who are likely to give birth to neonates with a large head, possess birth canals that are shaped to better accommodate large-headed neonates. Short females with an increased risk of cephalopelvic mismatch possess a rounder inlet, which is beneficial for obstetrics. We suggest that these covariances have evolved by the strong correlational selection resulting from childbirth. Although males are not subject to obstetric selection, they also show part of these association patterns, indicating a genetic-developmental origin of integration.

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Section: Fig 2 Sexual Dimorphism In the Human Pelvis (A)mentioning

confidence: 99%

Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma

Fischer

Mitterœcker

2015

Proc. Natl. Acad. Sci. U.S.A.

105

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“…According to Yong and Ince [19], these proportions of the inlet are similar to the pelvic inlet in males. Parameters of this cluster are similar to the pelvic diameters of the females who had the emergency cesarean section due to dystocia [12,10]. Therefore, this cluster is potentially problematic from an obstetrical perspective.…”

Section: Discussionmentioning

confidence: 66%

“…Stalberg at al. [12] demonstrated that a narrow pelvic midplane is an important reason for the emergency cesarean section. In addition, an inadequate proportion of the pelvic inlet also causes cesarean section [1].…”

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confidence: 99%

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Female pelvis types and age differences in their distribution

Koļesova

Vētra

2012

PoA

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The aim of this study was a statistics-based exploration of a typology of the female pelvis. The research sample included 172 females aged from 18 to 69. For measurements, the three dimensional CT images of pelvis were used. A cluster analysis was performed on anteroposterion and transverse diameters of the pelvic inlet and the midplane. The results revealed three clusters representing gynecoid, "narrow", and intermediate types of female pelvis. The distribution of pelvic types in age groups indicates a tendency for the "narrow" pelvis to be presented more frequently in the group of younger females.Variability and typology of the female pelvis is a traditional topic in anthropological studies [3,4,13,17]. The best known classification of the female pelvis was suggested by Caldwell and Moloy in 1933 [3] and it was based on the pelvic inlet shape. In the frame of this classification, four main pelvic types were suggested: gynecoid, android, anthropoid, and platypelloid. The development of this classification resulted in the identification of the mixed types and subtypes based on the width of the pelvic outlet [3]. As a result, more than twenty subtypes were suggested that complicated their analytical implication. In addition, the critics of this classification addressed the subjective impression in the judgments of pelvic shapes without a well established statistical base [19].A tendency of increase in cesarean section is observed in the last decades [2,5,9,15]. In Latvia, the number of cesarean section delivery is growing from 3. 9% in 1980 to 23.7% in 2010 [18]. A narrow pelvis is one of the factors increasing the risk for cesarean section [12]. On the one hand, there is a solution for the narrow pelvis problem from the obstetric perspective. On the other hand, a more detailed analysis is needed from the anthropological perspective because of possible evolutionary trends in the human body in general OKSANA KOLESOVA, JĀNIS VĒTRA

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“…Nonetheless, the conflicting demands of each have created an obstetric dilemma whereby childbirth is rendered difficult as women's hips are only just wide enough to allow an infant to be born (Rosenberg, 1992;Rosenberg & Trevathan, 2002;Wittman & Wall, 2007). Further complications are caused by neonate size remaining relatively constant regardless of variations in maternal size (Butte & King, 2005;Mohanty et al, 2006), which places those with narrow pelvic outlets at greatest risk of Cephalopelvic Disproportion (CPD) (Stålberg, Bodestedt, Lyrenäs, & Axelsson, 2006;Thurnau, Hales, & Morgan, 1992).…”

Section: Introductionmentioning

confidence: 99%

Evidence to Suggest that Women’s Sexual Behavior is Influenced by Hip Width Rather than Waist-to-Hip Ratio

2014

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Waist-to-hip ratio (WHR) is an important ornament display that signals women's health and fertility. Its significance derives from human development as a bipedal species. This required fundamental changes to hip morphology/musculature to accommodate the demands of both reproduction and locomotion. The result has been an obstetric dilemma whereby women's hips are only just wide enough to allow the passage of an infant. Childbirth therefore poses a significant hip width related threat to maternal mortality/risk of gynecological injury. It was predicted that this would have a significant influence on women's sexual behavior. To investigate this, hip width and WHR were measured in 148 women (M age = 20.93 + .17 years) and sexual histories were recorded via questionnaire. Data revealed that hip width per se was correlated with total number of sexual partners, total number of one night stands, percentage of sexual partners that were one night stands, number of sexual partners within the context of a relationship per year sexually active, and number of one night stands per year sexually active. By contrast, WHR was not correlated with any of these measures. Further analysis indicated that women who predominantly engaged in one night stand behavior had wider hips than those who did not. WHR was again without effect in this context. Women's hip morphology has a direct impact on their risk of potentially fatal childbirth related injury. It is concluded that when they have control over this, women's sexual behavior reflects this risk and is therefore at least in part influenced by hip width.

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A narrow pelvic outlet increases the risk for emergency cesarean section

Abstract: A narrow pelvic outlet is associated with an increased risk of emergency CS because of protracted labor. A postpartum pelvimetry is recommended and should be used when to decide on route of delivery in forthcoming pregnancies.

Cited by 29 publications

References 25 publications

Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma

Covariation between human pelvis shape, stature, and head size alleviates the obstetric dilemma

Female pelvis types and age differences in their distribution

Evidence to Suggest that Women’s Sexual Behavior is Influenced by Hip Width Rather than Waist-to-Hip Ratio

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