Difference between revisions of "Pelvimetry"

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A review in 2003 considered routine performance of pelvimetry to be a waste of time, a potential liability, and an unnecessary discomfort.<ref name="Blackadar2004">{{cite journal | vauthors = Blackadar CS, Viera AJ | title = A retrospective review of performance and utility of routine clinical pelvimetry | journal = Family Medicine | volume = 36 | issue = 7 | pages = 505–7 | date = 2004 | pmid = 15243832 }}</ref> A woman's pelvis loosens up before birth by hormones, so an investigation before labor do not represent the physiologic capacity of the birth canal. Still, pelvimetry can be indicated when a woman has had failure to progress in a previous pregnancy.
 
A review in 2003 considered routine performance of pelvimetry to be a waste of time, a potential liability, and an unnecessary discomfort.<ref name="Blackadar2004">{{cite journal | vauthors = Blackadar CS, Viera AJ | title = A retrospective review of performance and utility of routine clinical pelvimetry | journal = Family Medicine | volume = 36 | issue = 7 | pages = 505–7 | date = 2004 | pmid = 15243832 }}</ref> A woman's pelvis loosens up before birth by hormones, so an investigation before labor do not represent the physiologic capacity of the birth canal. Still, pelvimetry can be indicated when a woman has had failure to progress in a previous pregnancy.
  
;Choice of investigation
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;Choice of modality
 
Low-dose 3D CT can be used for estimating pelvimetry parameters.<ref name=Cetin2016>{{cite journal | vauthors = Salk I, Cetin A, Salk S, Cetin M | title = Pelvimetry by Three-Dimensional Computed Tomography in Non-Pregnant Multiparous Women Who Delivered Vaginally | journal = Polish Journal of Radiology | volume = 81 | issue = | pages = 219–27 | date = 2016 | pmid = 27231494 | pmc = 4865272 | doi = 10.12659/PJR.896380 }}</ref>
 
Low-dose 3D CT can be used for estimating pelvimetry parameters.<ref name=Cetin2016>{{cite journal | vauthors = Salk I, Cetin A, Salk S, Cetin M | title = Pelvimetry by Three-Dimensional Computed Tomography in Non-Pregnant Multiparous Women Who Delivered Vaginally | journal = Polish Journal of Radiology | volume = 81 | issue = | pages = 219–27 | date = 2016 | pmid = 27231494 | pmc = 4865272 | doi = 10.12659/PJR.896380 }}</ref>
  

Revision as of 18:47, 6 November 2018

Author: Mikael Häggström [notes 1]

Planning

Indication

A review in 2003 considered routine performance of pelvimetry to be a waste of time, a potential liability, and an unnecessary discomfort.[1] A woman's pelvis loosens up before birth by hormones, so an investigation before labor do not represent the physiologic capacity of the birth canal. Still, pelvimetry can be indicated when a woman has had failure to progress in a previous pregnancy.

Choice of modality

Low-dose 3D CT can be used for estimating pelvimetry parameters.[2]

Measurement

Parameter Image
(maximum intensity projection)
Definition Normal measures
Pelvic inlet Transverse diameter of the pelvic inlet 170px 13 to 14.5 cm.[2]
Obstetric conjugate 120px
Median plane
The line between the narrowest bony points formed by the sacral promontory and the inner pubic arch 10 to 12 cm.[2]
Pelvic outlet Interspinous distance 170px The line between the narrowest bone points connects the ischial spines 9.5 to 11.5 cm.[3]
Sagittal pelvic outlet diameter 120px 9.5 to 11.5 cm.[3]
Intertuberous diameter 150px 10 to 12 cm.[3]

Interpretation

This only needs to be done if requested by the clinician, otherwise it is only necessary to state the numerical values of the parameters.

Normal Borderline Narrow
Pelvimetry interpretation[4]
Sum of inlet measures >24 cm 23- 24 cm < 23 cm
Sum of outlet measures >31,5 cm 29,5 – 31,5 cm <29,5 cm
Obstetric conjugate >11,0 9,5 – 11,0 <9,5

A sagittal outlet is < 8 cm or interspinous diameter is <7 cm is regarded as narrow, even if the sum of outlet measures is normal.[4]

Report

The length of each of the distances above, but make an interpretation of any narrowing only if requested.

If the images are taken during a pregnancy, note the position of the fetus.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. "A retrospective review of performance and utility of routine clinical pelvimetry ". Family Medicine 36 (7): 505–7. 2004. PMID 15243832. 
  2. 2.0 2.1 2.2 "Pelvimetry by Three-Dimensional Computed Tomography in Non-Pregnant Multiparous Women Who Delivered Vaginally ". Polish Journal of Radiology 81: 219–27. 2016. doi:10.12659/PJR.896380. PMID 27231494. 
  3. 3.0 3.1 3.2 "Magnetic resonance pelvimetry for trial of labour after a previous caesarean section ". Sultan Qaboos University Medical Journal 10 (2): 210–4. August 2010. PMID 21509231. 
  4. 4.0 4.1 Kira Kersting (2017-01-04). Kronoberg County Council.