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PubMed2001

Experience with computed tomography (CT) pelvimetry in Ibadan, Nigeria: a preliminary report.

Computed tomography (CT) pelvimetry has largely replaced conventional radiography in the antenatal assessment of pelvic dimensions, but its usefulness in the Nigerian setting is yet to be assessed. This study was undertaken to ascertain if there is a relationship between antenatal CT pelvimetric measurements and the mode of delivery at the end of the pregnancy. A group of thirty-one patients who had antenatal pelvimetry were categorised into two groups depending on whether they achieved vaginal delivery or not and the pelvimetric and other obstetrrc characteristics of the two groups were compared. The only parameters that showed statistically significant differences between the groups were the higher maternal height and the lower head circumference in the neonates of women achieving vaginal delivery. The findings suggest that fetal parameters may be more predictive of mode of delivery than absolute pelvic measurements.

Birth Weight↗
PubMedDate not supplied

[Critical assessment of clinical pelvimetry in the estimation of mechanical dystocia].

The authors followed 82 cesarean sections done for negative labor trial during one year in the Maternity "Elena Doamna" Iaşi. Each case was assessed after age, obstetrical history, labor trial, presentation, weight and Apgar score of the new born. Internal or external pelvimetry had sometimes advantages but also restrictions because many etiologies of mechanical dystocia of the labor disappeared. Therefore even now with normal clinical pelvimetry and normal fetuses a labor trial can be negative.

Adult↗
PubMed1991

[Pelvimetry].

It has been shown that, in all the different ways of performing pelvimetry, use of computed tomographic techniques leads to a significant reduction in radiation doses. We describe a new method of pelvimetry, involving computed tomography consisting of two scoutviews. The results of this method are compared with the results of conventional technique ad modum Fernström, measured in 55 women. Both methods showed large inter-observator differences. No statistically significant differences between the methods were revealed but the anteroposterior outlet was slightly smaller with the CT-technique (mean 6 mm). The method is recommended, since it is easy to use, and the rate of ionizing radiation is low.

Female↗
PubMed1991

X-ray pelvimetry-reappraisal.

Antenatal erect lateral X-ray pelvimetry was performed for 116 primigravidas and 53 multigravidas because of suspected cephalopelvic disproportion (CPD). Multigravidas were further subgrouped into 4 gravidas and greater than 4 gravidas. In the primigravidas, there was no statistical difference in the mean value of the anteroposterior diameter of the pelvic inlet (APD) of the elective (10.4 cm, +/- 0.6 SD) and the emergency (10.5 cm, +/- 0.9 SD) caesarean section group. In the multigravidas, the mean value of the APD showed a statistically significant decrease with increased parity. In this group, the chances of delivery by caesarean section were 74%, when the APD was less than 10.5 cm, and 12% if the APD was greater than 11.5 cm. It is concluded that cephalopelvic disproportion in primigravidas should only be diagnosed after adequate trial of labour with adequate uterine contractions. In multiparous patients, especially grand multiparas, X-ray pelvimetry is recommended in cases of suspected CPD before a trial of vaginal delivery is conducted, since the mode of delivery seems to depend primarily on the pelvic capacity.

Birth Weight↗
PubMed1990

Radiographic pelvimetry for the estimation of pelvic dimensions in Merino, Dormer and S A mutton Merino ewes.

Investigations into ovine pelvic size and its relationship to repetitive rearing failure require accurate estimation of pelvic dimensions in live animals. Radiographic pelvimetry was used to estimate pelvic dimensions of 84 Merino, 21 Dormer and 20 S A Mutton Merino ewes. Transverse diameter and conjugate diameter were estimated; the area of the pelvic inlet was defined as the product of transverse and conjugate diameters. Dissected measurements obtained from all ewes after slaughter were regressed on estimated dimensions to obtain prediction equations for the correction of radiographic estimates. Prediction equations for the estimation of dissected pelvic dimensions from radiographs were accurate (r greater than or equal to 0.87), irrespective of dimension estimated or breed. Derived equations for estimation of dissected pelvic dimensions for the 3 breeds were not statistically different. It was concluded that pelvic dimensions of ewes could accurately be predicted by radiographic pelvimetry.

Animals↗
PubMed1986

Frequency and efficacy of pelvimetry: Saskatoon experience.

The pelvimetry rate in Saskatoon for the period 1979-1981 was low in comparison with published rates. Pelvic measurements alone are poor predictors of the outcome of labor. Management usually proceeded independently of these measurements. There was substantial variability among ten different observers in measuring the same set of pelvimetry films.

Canada↗
PubMed1986

[Pelvimetry by digitalized radiography].

We studied the ability of digital radiographs generated on a computed tomography scanner to replace conventional pelvimetry. Two digital radiograph's and one CT section permit us to measure the maternal pelvis. The anteroposterior digital radiograph allows measurement of the maximum transverse and median transverse diameters of the pelvic inlet. These two distances are corrected for magnification after reference to the lateral digital radiograph and to a graph determined owing to a phantom. The anteroposterior digital radiograph also permits to perform a CT section passing through the ischial spines with direct measurement of the inter spinous diameter. The lateral digital radiograph gives us the true values for the anteroposterior diameter of the pelvic inlet, the low sagittal diameter, the cord and the rise of the sacrum. The dosimetry studies demonstrated that maternal skin doses and fetal gonad doses were very low. Pelvimetry using digital radiography is a simple and rapid to perform procedure which offers the advantage of low radiation exposure to both fetus and mother and a high accuracy of measurement.

Female↗
PubMed1985

A vaginal delivery protocol for the term breech infant utilizing ball pelvimetry.

Ball pelvimetry has been utilized at the Medical Center Hospital of Vermont to evaluate infants with breech presentation for vaginal delivery. That technique provided measurements of both the fetal head volume and maternal pelvic capacity so that relative fetomaternal relationships could be established. Between January 1979 and December 1981, 107 patients in spontaneous labor with term pregnancy were evaluated with the protocol. Inadequate pelvimetry and hyperextension of the fetal head occurred in 21 patients (20%). Of the 86 patients who were allowed to labor, 51 (59%) had a vaginal delivery. The total cesarean section rate was 52%. Vaginal delivery in our highly selected patient population did not increase neonatal morbidity. There were no neonatal deaths.

Adolescent↗
PubMed1983

A pelvimetry method for predicting perinatal mortality in pregnant squirrel monkeys (Saimiri sciuresus).

High perinatal mortality has impaired the reproductive performance of female squirrel monkeys in captivity. A pelvimetry method as a potential predictor of pregnancy outcome was devised to evaluate the bony pelvic structures of females for which records of previous pregnancies were available. By utilizing lateral and anteroposterior radiographic views of the pelvis, the inlet, the midpelvis, and the outlet were measured. In the colony, 21 females had livebirths, 13 delivered dead term fetuses (stillbirths), and six aborted. Comparison of the pelvic outlet of the females with liveborn fetuses (1.81 +/- 0.12 cm) with those which had stillbirths (1.64 +/- 0.09 cm) revealed a highly significant difference (p less than 0.001). Discriminant analysis demonstrated a 95.2% predictability of females which had liveborn and a 92.1% rate in females with stillborn fetuses. Pelvimetry may be a useful tool in predicting pregnancy outcome, as narrow pelvic outlets were consistently observed in females that delivered stillborn infants.

Animals↗
PubMed1980

Efficacy of pelvimetry.

One hundred and fifty-four pelvimetry examinations were reviewed. The study suggests that radiographic pelvimetry is of little prognostic value and that decision for cesarean section is usually based on clinical factors.

Cesarean Section↗
PubMed1994

Assessment of computed tomographic pelvimetry within a selective breech presentation management protocol.

A vital component of selective protocols in term breech presentation management is exclusion of the gravida with borderline pelvic dimensions. Computed tomographic (CT) pelvimetry was employed to evaluate potential candidates for a trial of labor with a breech fetus at term. Thirty-seven of 39 women who underwent labor after this selection had a successful assisted vaginal breech delivery. Adequate pelvic dimensions by CT pelvimetry reliably predicted a safe vaginal delivery in patients managed within a standard breech protocol.

Breech Presentation↗
PubMedDate not supplied

[Methods, techniques and assessment criteria in obstetric pelvimetry].

Size and shape of the bony pelvis are important factors determining the progress of labor and delivery. Clinical evaluation of the pelvis and sonographic examination of the fetal size are important tools for the planning of labor and in most cases allow to diagnose cephalopelvic disproportion. Pelvimetry by computed tomography (CT) and by magnetic resonance imaging (MRI) are exact and simple techniques with low or absent ionizing radiation. These new techniques offer distinct advantages over conventional X-ray pelvimetry. However, the value of the measurements of the pelvic dimensions in predicting labor outcome and in the diagnosis of cephalopelvic disproportion remains limited. Only if the pelvimetric data are combined with data on fetal dimensions obtained by ultrasound or by postpartum measurements, the efficacy of the examination in predicting the success of labor and identifying the presence or absence of cephalopelvic disproportion is increased. This combination therefore may confirm the diagnosis of cephalopelvic disproportion after operative delivery, which is important with respect to subsequent deliveries. Furthermore this method could play and important role in selecting patients with term breech presentation for possible vaginal delivery.

Cesarean Section↗
PubMed1997

[Breech delivery. Selection by X-ray pelvimetry].

An attempt was made to evaluate the possible benefit of selecting women for vaginal breech delivery at term by radiological pelvimetry. Information from medical records on 276 singleton breech deliveries were analysed. A total of 188 breech presentations were diagnosed before the onset of labour, pelvimetry was performed in 74 women, where pelvic dimensions too small for recommendation of vaginal breech delivery were found in 30 cases. The overall rate of caesarean section was 78%, among diagnosed patients it was 84% and 64% among undiagnosed breech presentations. Rates of morbidity (low Apgar score and admission to the neonatal care unit) did not differ significantly between infants delivered vaginally or by elective caesarean section. The material, however, is too small for valid conclusions regarding safety of vaginal delivery of term breech in women selected by criteria including estimate of pelvic size.

Adult↗
PubMed2006

Magnetic resonance imaging pelvimetry in 186 patients with rectal cancer confirms an overlap in pelvic size between males and females.

INTRODUCTION: It has generally been considered that open pelvic surgery is almost always easier in female subjects because of anatomical differences facilitating surgical access. In contrast, the male pelvis has been considered to be narrower and deeper. The objective of this study was to assess magnetic resonance imaging (MRI) pelvimetry in patients with rectal cancer in whom any difference in pelvimetry may potentially affect operative management. Male and female pelvic bony dimensions were compared. METHOD: A cohort of 186 patients (112 males and 74 females) with rectal cancer who had been recruited prospectively to the Magnetic Resonance Imaging and Rectal Cancer European Equivalence Study (MERCURY Study) were assessed. Complete digital images were available on these patients. A comparison of the pelvic dimensions was made between the sexes using 16 dimensions measured on the MRI workstation using the mid-sagittal and axial images. RESULTS: There was no significant difference and considerable overlap between the sexes with respect to each of the 14 parameters measured from the preoperative sagittal MRI scan. However, there was a highly significant difference between the interspinous and intertuberous transverse diameter of the pelvis (P < 0.0001). CONCLUSION: Outcome after surgery may be influenced by the technical difficulty of the operation and this had been thought to be partly affected by the pelvic size. In this cohort of 186 patients, the only difference seen between the sexes, was in the transverse mid-inlet and pelvic outlet diameter.

Adult↗
PubMed2000

Association between external pelvimetry and vertex delivery complications in African women.

OBJECTIVE: To assess association between external pelvimetry and delivery complications in vertex presentation. METHODS: Prospective cohort study of 2,413 pregnant women antenatally measured for height and external pelvimetry in four hospitals of the former Republic of Zaire. OUTCOME MEASURES: Complications during delivery of single fetus weighing 2,000 g or more in vertex presentation. Cut-off values at risk for delivery complications were height and pelvic distances closest to the study population 10th percentile. RESULTS: In univariate analysis, maternal height showed significant relative risk for predicting primary cesarean section for failure to progress: 2.0 (95% CI=1.0-4.1; p=0.050) and vacuum or forceps delivery: 15.7 (95%, CI=6.6-37.5; p<0.001). Selected external pelvic distances showed significant relative risks for predicting the following complications: primary cesarean section for failure to progress, elective repeat cesarean section, vacuum or forceps delivery and spontaneous intrapartum stillbirth. Among pelvic predictors, transverse diagonal (TD) of Michaelis sacral rhomboid area was associated with all of these complications. Intertrochanteric (IT) diameter was associated with three of them. The relative risks ranged from 2.3 (95% CI=1.1-6.3; p=0.030) to 9.6 (95% CI=4.1-22.5; p<0.001) for these strongest predictors. CONCLUSIONS: External pelvic distances help to predict vertex delivery complications in African women. The predicted complications are compatible with the cephalopelvic disproportion concept (CPD). After validation of current results in a separate cohort, measurements of IT and/or TD are recommended to improve antenatal screening of women at risk for CPD in limited resources settings.

Adolescent↗
PubMed1976

A prerecorded program for the Ball pelvimetry technique.

Pelvimetry can be simplified by a recently devised computer program. The program can be used with any of several advanced programmable pocket or desk-top calculators. This approach is more accurate than either the nomogram or the slide rule, and demands much less time and attention.

Computers↗
PubMed1985

X-ray pelvimetry in a breech protocol: a comparison of digital radiography and conventional methods.

X-ray evaluation of the pelvis plays a pivotal role in selecting term breech presentation for a possible trial of labor. Even minimal degrees of disproportion may have disastrous consequences for the aftercoming head. Our evaluation of x-ray pelvimetry by computerized tomography scanning suggests it is probably more accurate than conventional methods, with a concomitant decrease in fetal x-ray exposure.

Breech Presentation↗
PubMed1975

A computerized aid to Ball pelvimetry.

A computer program is presented that will generate a table of capacities and volumes for use with the Ball technique for cephalopelvimetry. The technique of Ball pelvimetry is reviewed and directions for use are described. This table may be produced on any medium or large-scale digital computer equipped with a FORTRAN compiler and a standard page printer. Its use eliminates many errors inherent in previous methods of volume computation. Physician acceptance has been excellent.

Cephalometry↗