Difference between revisions of "Pelvimetry"

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(+Report)
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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>
  
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==Interpretation==
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==Measurement==
 
{|class="wikitable"
 
{|class="wikitable"
 
!colspan=2| Parameter !! Image<br>([[maximum intensity projection]]) !! Definition !! Normal measures  
 
!colspan=2| Parameter !! Image<br>([[maximum intensity projection]]) !! Definition !! Normal measures  
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| 10 to 12&nbsp;cm.<ref name=Cetin2016/>  
 
| 10 to 12&nbsp;cm.<ref name=Cetin2016/>  
 
|-
 
|-
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! colspan=2| Interspinous distance
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! rowspan=3| Pelvic outlet
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! Interspinous distance
 
| [[File:Low-dose_CT_of_interspinous_diameter.jpg|170px]]
 
| [[File:Low-dose_CT_of_interspinous_diameter.jpg|170px]]
 
| The line between the narrowest bone points connects the ischial spines
 
| The line between the narrowest bone points connects the ischial spines
 
| 9.5 to 11.5&nbsp;cm.<ref name="pmid21509231">{{cite journal | vauthors = Gowri V, Jain R, Rizvi S | title = Magnetic resonance pelvimetry for trial of labour after a previous caesarean section | journal = Sultan Qaboos University Medical Journal | volume = 10 | issue = 2 | pages = 210–4 | date = August 2010 | pmid = 21509231 | pmc = 3074700 }}</ref>
 
| 9.5 to 11.5&nbsp;cm.<ref name="pmid21509231">{{cite journal | vauthors = Gowri V, Jain R, Rizvi S | title = Magnetic resonance pelvimetry for trial of labour after a previous caesarean section | journal = Sultan Qaboos University Medical Journal | volume = 10 | issue = 2 | pages = 210–4 | date = August 2010 | pmid = 21509231 | pmc = 3074700 }}</ref>
 
|-
 
|-
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! rowspan=2| Pelvic outlet
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! Sagittal pelvic outlet diameter
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! Sagittal pelvic outlet diameter¨
 
 
| [[File:Low-dose_CT_of_sagittal_pelvic_outlet_diameter.jpg|120px]]
 
| [[File:Low-dose_CT_of_sagittal_pelvic_outlet_diameter.jpg|120px]]
 
|  || 9.5 to 11.5 cm.<ref name="pmid21509231"/>
 
|  || 9.5 to 11.5 cm.<ref name="pmid21509231"/>
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|  || 10 to 12 cm.<ref name="pmid21509231"/>
 
|  || 10 to 12 cm.<ref name="pmid21509231"/>
 
|}
 
|}
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 +
==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.
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 +
{|class="wikitable"
 +
!  !! Normal !! Borderline !! Narrow
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|+ Pelvimetry interpretation<ref name=Kersting>{{cite web|url=http://dokpub.regionkronoberg.se/OpenDoc.aspx?Id=71912|Pelvimetry (in Swedish: Bäckenmätning)|title=Kronoberg County Council|author=Kira Kersting|date=2017-01-04}}</ref>
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|-
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| Sum of inlet measures || >24 cm || 23- 24 cm || < 23 cm
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|-
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| Sum of outlet measures || >31,5 cm || 29,5 – 31,5 cm || <29,5 cm
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|-
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| Obstetric conjugate || >11,0 || 9,5 – 11,0 ||<9,5
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|}
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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.<ref name=Kersting/>
  
 
==Report==
 
==Report==

Revision as of 12:26, 5 July 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 investigation

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 Low-dose CT of transverse diameter of pelvic inlet.jpg 13 to 14.5 cm.[2]
Obstetric conjugate Low-dose CT of obstetric conjugate.jpg
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 Low-dose CT of interspinous diameter.jpg The line between the narrowest bone points connects the ischial spines 9.5 to 11.5 cm.[3]
Sagittal pelvic outlet diameter Low-dose CT of sagittal pelvic outlet diameter.jpg 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, and a mention of whether any is decreased.

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.


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