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PubMed1987

[Pelvimetry using x-ray computed tomography].

The accuracy and the low radiation dosage administered when tomodensitometry is carried out for pelvimetry has led us to specify the use of this technique in every day practice. We propose to make is still more reliable and to simplify it. We have correlated the measurements obtained on the ultrasound screen with those that have been obtained by measuring the dried pelvis and have sought ways of measuring directly the three fundamental diameters of the pelvis. We have achieved exact measurements within one millimeter. This very precise correlation has been reproduced when we examined skeletons using the tomodensitometer. Then, when we checked again the accuracy of these measurements, we used the method on pregnant women. We have taken two views and two slices: an AP view to study the contents of the uterus and the morphology of the upper strait; a profile view to measure the diameter between the promontory of the sacrum and posterior surface of the symphysis, and we have programmed the two following slices: a perpendicular slice at the level of the upper strait measuring directly the transverse median diameter; another slice at the level of the sciatic spines to measure directly the diameter between these spines. We present this method because it is very simple and absolutely precise and gives all the information that is necessary. The patient does not have to stay still for long and only has a small dose of irradiation. This procedure does not need the use of conversion tables, nor parallel rulers nor standardisation.

Female↗
PubMed1985

The value of X-ray pelvimetry in previous caesarean section pregnancies.

The results of erect lateral X-ray pelvimetry in a retrospective study of 100 randomly selected patients who had undergone previous caesarean section for a variety of indications were analysed. The indication for caesarean section was compared with subsequent pregnancy outcome. The inlet diameter and sacral shape were not found to be of great predictive value. Radiological engagement of the fetal head was associated with a 90% incidence of vaginal delivery.

Cesarean Section↗
PubMedDate not supplied

Pelvimetry of Chinese females with special reference to pelvic type and maternal height.

A total of 1619 x-ray pelvimetries were analyzed to establish whether there are any differences in pelvic measurements between the four pelvic types. Of these, 1367 were analyzed to find out the relation between the capacity of each pelvic plane and maternal height. Of the 1619 cases, 564 (34.8%) were gynecoid. 330 (20.4%) anthropoid, 277 (17.1%) android and 448 (27.7%) platypellic. There were considerable differences in pelvic measurements among the four types; android pelves have smaller diameters than gynecoid and anthropoid pelves. These findings suggest that pelvic types classified on the basis of impression alone may have a prognostic significance regarding the course of labor. Maternal height has a positive correlation with pelvic measurements; this correlation is greater at the inlet than at midplane and outlet and is, moreover, more evident in gynecoid and platypellic than in anthropoid and android pelves. If maternal height is less than 150 cm, there is great probability that inlet capacity will be less than average; if it is less than 145 cm. low borderline contraction is highly probable.

Asian People↗
PubMedDate not supplied

Relevance of clinical pelvimetry to obstetric practice in developing countries.

The outcome of labour in 177 Nigerian primigravidae in whom clinical pelvic assessment was performed before delivery, is studied. No significant difference occurred in the mode of delivery for the rank of the pelvic assessors (consultants or resident doctors) at x = 0.05. No significant difference also occurred in the incidence of caesarean section between the pelvic assessed and the unassessed patients, and between those whose pelves were assessed adequate and those assessed inadequate. One-minute Apgar scores were significantly higher for fetuses delivered of women with adequate pelves compared to those with (i) borderline pelves (Z = 3.46, p < 0.001), (ii) unassessed pelves (Z = 2.84, p < 0.005) and (iii) the not adequate pelves-borderline and inadequate (Z = 3.04, p < 0.005), thereby conferring a predictive role on Apgar scores to clinical pelvimetry. The procedure is cost-free and requires minimal guidance to perfect. Its continued practice in routine ante-natal care in developing countries is therefore advocated.

Apgar Score↗
PubMed1997

Combination of ultrasound pelvimetry and fetal sonography in predicting cephalopelvic disproportion.

OBJECTIVE: To assess a method of antepartum diagnosis of cephalopelvic disproportion by comparing the diameters of fetal head with those of the maternal midpelvis. METHODS: Transvaginal ultrasound pelvimetry was performed on 190 healthy primigravidas with cephalic presentation at 28-35 weeks of gestation, and the fetal heads were measured within one week before delivery. The cephalopelvic indices of diameter, circumference and area were calculated and compared. RESULTS: The index exhibiting the highest degree of accuracy (77.9%) was the cephalopelvic index of diameter (CID) defined as the difference between the mean diameter of the midpelvis and the fetal biparietal diameter (BPD). Eighty-three percent of the cases with CID less than 15.8 mm needed operative delivery, and 76.2% of the cases with CID more than 15.8 mm underwent vaginal delivery. CONCLUSIONS: The CID may be used to identify cephalopelvic disproportion before the labor and help obstetricians choose the most appropriate form of delivery in an uncomplicated vertex presentation.

Cephalometry↗
PubMedDate not supplied

Twenty degree angle modification for pelvimetry.

The standard Colcher-Sussman pelvimetry technique does not adequately visualize the interischial distance on a significant number of patients. A twenty-degree angulation modification has been developed to solve this problem.

Female↗
PubMed1979

Radiation doses in low-dose pelvimetry using rare-earth screens.

A 'low-dose technique' of obstetric pelvimetry, using rare-earth screens and a reduced ambition level of image quality, yields an estimated absorbed dose to the maternal and foetal gonads of 0.9 and 0.01 mGy, respectively. The resulting risk for 'hereditary ill health' and the risk for induction of leukemia from the absorbed dose to the foetal red bone marrow, have been calculated to be at a very low level.

Female↗