The birth canal: correlation between the pubic arch angle, the interspinous diameter, and the obstetrical conjugate: a computed tomography biometric study in reproductive age women

Perlman, Sharon; Raviv-Zilka, Lisa; Levinsky, Denis; Gidron, Ayelet; Achiron, Reuven; Gilboa, Yinon; Kivilevitch, Z.

doi:10.1080/14767058.2018.1462322

Cited by 19 publications

(21 citation statements)

References 29 publications

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“…The change in one diameter shows a linear relationship to the other diameters of the birth canal's pelvic space, suggesting a coordinated movement of the pelvis as a whole. An MR pelvimetry study in supine static position confirmed a similar correlation between the obstetric conjugate, the sub-pubic arch angle, and the inter-spinous diameter [26].…”

Section: Figure 5: Pelvic Anteroposterior Diameters In Shifting Positmentioning

confidence: 53%

“…The obstetric conjugate is one of the anteroposterior diameters of the pelvic inlet. It was selected as the obstructed labor best-predictor in MR and ultrasound research literature [10,18,[24][25][26]. The external anteroposterior diameter of the pelvic inlet increases in the present study from the straight-leg to the kneeling squat position.…”

Section: Figure 5: Pelvic Anteroposterior Diameters In Shifting Positmentioning

confidence: 99%

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Dynamic External Pelvimetry Test in Third Trimester Pregnant Women: Shifting Positions Affect Pelvic Biomechanics and Create More Room in Obstetric Diameters

Siccardi¹,

Valle

Matteo

2021

Cureus

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Dystocia in labor is still a clinical challenge. The "contracted pelvis" is the absence of pelvic mobility, which leads to fetal-pelvic disproportion, obstructed labor, and operative delivery. Maternal pelvis biomechanics studies by high technological techniques have shown that maternal shifting positions during pregnancy and labor can create more room in the pelvis for safe delivery. The external and internal pelvic diameters are related. The present study aims to evaluate the external obstetric pelvic diameters in shifting positions using a clinical technique suitable for daily practice in every clinical setting: the dynamic external pelvimetry test (DEP test). Seventy pregnant women were recruited, and the obstetric external pelvic diameters were measured, moving the position from kneeling standing to "hands-and-knees" to kneeling squat position. Results showed modification of the pelvic diameters in shifting position: the transverse and longitudinal diameters of Michaelis sacral area, the inter-tuberosities diameter, the bi-trochanters diameter, and the external conjugate widened; the bi-crestal iliac diameter, the bi-spinous iliac diameter, and the base of the Trillat's triangle decreased. The test showed good reproducibility and reliability. Linear correlations were found between diameters and between the range of motion of the diameters. The maternal pelvis is confirmed to modify the diameters changing its tridimensional shape. The pelvic inlet edge's inclination is inferred to be modified, facilitating the fetal descend. The pelvic outlet enlarged the transverse diameter, facilitating birth. The DEP test estimates the pelvic diameters' modification with postural changes, as magnetic resonance (MR) and computational biomechanics studies have demonstrated.

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Section: Figure 5: Pelvic Anteroposterior Diameters In Shifting Positmentioning

confidence: 53%

Section: Figure 5: Pelvic Anteroposterior Diameters In Shifting Positmentioning

confidence: 99%

Dynamic External Pelvimetry Test in Third Trimester Pregnant Women: Shifting Positions Affect Pelvic Biomechanics and Create More Room in Obstetric Diameters

Siccardi¹,

Valle

Matteo

2021

Cureus

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“…We did not explore the role of maternal factors and techniques such as sonographic pelvimetry in the need for Cesarean delivery in our patient cohort. Some recent studies have suggested a role for pelvimetry, measured using computed tomography or magnetic resonance imaging, for identification of those at high risk of cephalopelvic disproportion 26,27 . Combining maternal sonographic pelvimetry with fetal adiposity in an effort to assess risk of unplanned intrapartum Cesarean delivery could form the basis of future work.…”

Section: Discussionmentioning

confidence: 99%

Sonographic markers of fetal adiposity and risk of Cesarean delivery

Hehir

Burke

et al. 2019

Ultrasound in Obstet & Gyne

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Increased fetal size is associated with labor dystocia and subsequent need for assisted delivery. We sought to investigate if increased fetal adiposity diagnosed sonographically was associated with increased risk of operative delivery. METHOD: The Genesis Study recruited 2,392 nulliparous patients with a vertex presentation in a prospective multicenter study to examine prenatal and intra-partum predictors of cesarean delivery. Participants had ultrasound and clinical evaluation performed between 39 0/7 and 40 6/7 weeks' gestation. Data on fetal biometry was not revealed either to patients or their managing clinicians. A fetal adiposity composite of fetal thigh adiposity and fetal abdominal thickness was compiled for each infant in order to clarify if fetal adiposity >90th centile was associated with an increased risk of cesarean or instrumental delivery. RESULTS: After exclusions data were available for 2,330 patients. Patients with a fetal adiposity composite >90 th centile had a higher maternal BMI (24±4 vs. 25±5; p=0.005), birthweight (3872 ± 417g vs. 3585 ± 401g; p<0.0001) and rate of induction of labor (47% [108/232] vs. 40% [834/2098]; p=0.048) than those patients with an adiposity composite d90 th centile. Fetuses with adiposity composite >90th centile were more likely to require cesarean delivery than fetuses with adiposity <90th centile (p<0.0001). After adjusting for birthweight, maternal BMI, and onset of labor, fetal adiposity >90th centile remained a risk factor for cesarean delivery (p<0.0001). A fetal adiposity composite >90 th centile was found to be more predictive of the need for unplanned cesarean delivery than an estimated fetal weight >90 th centile (OR= 2.20 [95%

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“…13 The pelvic inlet and midpelvis are important factors to the anthropological analysis of the female pelvic typology. 14 Nowadays evaluation of pelvic types based on clinical examination and imaging techniques including CT, MRI, radiography and US are available. 14,15 The previous studies have shown that pelvimetry with CT is convenient and accurate technique.…”

Section: Introductionmentioning

confidence: 99%

“…14 Nowadays evaluation of pelvic types based on clinical examination and imaging techniques including CT, MRI, radiography and US are available. 14,15 The previous studies have shown that pelvimetry with CT is convenient and accurate technique. 16 The assessment of pelvic types in addition to another anatomy parameters has clinical importance in predicting the procedures of pregnancy and childbirth in Evaluation of the link between pelvimetry based on computed tomography Shahla Mirgalobayat et al…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the link between pelvimetry based on computed tomography and predicting status’ delivery

2019

J. contemp. med. sci.

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Objectives The aim of this study is an anthropometric study in non-pregnant reproductive-aged women to predicting kind of delivery. Methods This study was based on the archived information of Hazrat-e Rasool university hospital on 157 generative age women from 16 to 60 years old who underwent CT between March 2015 and March 2018. Results The obtained results showed that the three conjugates on sagittal plane, transverse diameter, anteroposterior sagittal diameter, interspinous diameter, and intertuberous diameter on the coronal plane. The obstetrical conjugate was 123.3 mm in normal vaginal delivery and 113.9 mm in Cesarean section, which was slightly longer than delivery group. The mean interspinous and intertuberous diameters measured by CT scans were 105.0 and 107.4 mm. Conclusion The results of our study showed that because of the reduction in diameter of the inlet and middle pelvis, the rate of cesarean section was higher in females under 35 years ages. Keywords pelvimetry, computed tomography, non-pregnant women This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.

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The birth canal: correlation between the pubic arch angle, the interspinous diameter, and the obstetrical conjugate: a computed tomography biometric study in reproductive age women

Cited by 19 publications

References 29 publications

Dynamic External Pelvimetry Test in Third Trimester Pregnant Women: Shifting Positions Affect Pelvic Biomechanics and Create More Room in Obstetric Diameters

Dynamic External Pelvimetry Test in Third Trimester Pregnant Women: Shifting Positions Affect Pelvic Biomechanics and Create More Room in Obstetric Diameters

Sonographic markers of fetal adiposity and risk of Cesarean delivery

Evaluation of the link between pelvimetry based on computed tomography and predicting status’ delivery

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