Can the Dynamic External Pelvimetry Test in Late Pregnancy Reveal Obstructed and Prolonged Labor? Results From a Pilot Study

Abstract

BackgroundThe size and mobility of the maternal pelvic space are fundamental factors in successful childbirth and can allow operators to screen for dystocia. This pilot study including a group of 70 pregnant women aimed to test whether the external dynamic pelvimetry test can be used to predict the likelihood of obstructed labor. MethodologyThe study cohort consisted of 70 pregnant women in their third trimester. The cohort was divided retrospectively into an obstructed labor group and a control group. Obstructed labor was defined using the following obstetric outcomes: augmentation with oxytocin from the first phase of the dilating period, Kristeller's maneuvers, vacuum extractor (kiwi), forceps, and the cesarean section following the onset of labor. ResultsThe measurements obtained for the longitudinal hemi-diameter of Michaelis, the inter-tuberous diameter, and the base of the Trillat's triangle were statistically significant in every position. The difference in the measurements of the transverse diameter of Michaelis between standing and hands-and-knees position and the difference in the sizes of the bi-cristal diameter between hands-and-knees and squatting position were statistically significant. ConclusionsDimension and biomechanical properties of the pelvic tissue and spaces influence the evolutionary childbirth process. After clinical confirmation on a large population, hypomobility of specified external pelvic diameters measured in shifting positions can become a screening tool to detect the contracted pelvis and prevent damage caused by dystocia and prolonged labor in women and newborns.

Clarifying the relationship between obesity and pelvic dimensions

“…Also, a narrower greater pelvis was not connected with a higher probability of obstructed labour. 4 Second, the relationship between a history of obesity and pelvic dimension was more prominent among males than among females, probably as a result of adipose estrogenisation during pubertal development, which is not relevant in the case of females. 2 We are pleased to see the application of our work.…”