Compare the architectural differences in the bony pelvis of Korean women and their association with the mode of delivery by computed tomography

Abstract

ObjectiveWe investigated the structural differences in the pelvic bone architecture of Korean women and their association with the mode of delivery by performing computed tomography (CT) pelvimetry. MethodsThis study was conducted on 175 women who underwent CT between March of 2006 and May of 2008. For making an objective assessment, one specialist in obsterics and gynecology measured the obstetrical conjugate, the true conjugate and the diagonal conjugate on the sagittal plane and the transverse diameter, the intertuberous diameter and the interspinous diameter on the coronal plane. The patients who underwent total hysterectomy or those who had a disease of the uterus were excluded from the current analysis. ResultsA total of 175 Korean women were examined, and their ages ranged from 20 to 50 years. The mean age was 37.6 ± 7.4 years. The interspinous diameter that was measured on CT scans was 94.6 ± 7.8 mm in the vaginal delivery group (n=84) and this was 90.9 ± 6.6 mm in the cesarean section group (n=20). This difference reached statistical signifi cance. ConclusionOur study examined the difference in the pelvic architecture with using CT and we found that the interspinous diameter can be the important determinant that affects normal vaginal delivery. Of these pelvimetric parameters, a wider interspinous diameter was signifi cantly associated with vaginal delivery. Multi-displinary approaches are warranted to examine this relation with regard to the various factors that are involved in delivery. Th is is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Keywords Copyright © 2011. Korean Society of Obstetrics and GynecologyThe maternal bony pelvis is an important factor that affects the degree of soft tissue damage that occurs during parturition and for choosing the mode of delivery [1]. It is known that such factors as a spacious inlet, a large interspinous diameter and a wide suprapubic arch are associated with a normal vaginal delivery [1]. Childbirth is a major cause of pelvic prolapse, and so conducting anatomical studies on the materal pelvic structure are essential for examining the structural changes of the pelvic bone that occur during parturition and the possible subsequent prolapse of organs in the pelvic fl oor. However, there have been no such studies due to a lack of measurement methods in this fi eld. Recent studies [2][3][4] have found that computed tomography (CT) pelvimetry is easier to perform and more accurate and it causes less distortion than Korean J

The relation between obstetric conjugate diameter during pregnancy and the type of delivery: a narrative review

“…13 A computed tomography was conducted on 175 Korean women's (age ranged from 20 and 50 years) to predict the type of delivery (vaginal or cesarean), therefore, they observed that 84 women gave birth by normal vaginal delivery and their mean obstetric conjugate diameter was 119.6±9.5 mm, while 20 women were delivered by cesarean section was116.6±8.4 mm. 14 The obstetrical conjugate diameter was determined by a caliper in 114 Ghanaian women and presented that the obstetric conjugate diameter for women who delivered vaginally was 10.61±0.81 cm and those patients underwent cesarean section was 9.54±0.63 cm. 15 X-ray pelvimetry was performed on 391 Hon Kong women at 36 weeks pregnancy, 371 women were successfully vaginal delivery and their mean obstetric conjugate diameter was 11.67±0.79 cm, while 74 women were failed vaginal delivery was 11.46±0.72 cm.…”

“…12,13 For Korean women, the mean obstetric conjugate diameter was 119.6±9.5 mm for those who delivered vaginally, while was 116.6±8.4 mm for those who underwent cesarean section, for 114 Ghanaian women, the mean obstetric conjugate diameter in women who delivered vaginally was 10.61±0.81 cm and those patients underwent cesarean section was 9.54±0.63 cm, and for 391 Hon Kong, the mean obstetric conjugate diameter was 11.67±0.79 for those who delivered vaginally and it was 11.46±0.72 cm for those who underwent by cesarean. [14][15][16] Therefore, in women with an obstetric conjugate diameter smaller than 10 cm, the necessity could be predicted strongly. In the previous study on Indian pregnant women, ultrasonic tomography pelvimetry was showed that the obstetric conjugate diameter measured less than 10 cm was associated with a 100% cesarean section, 10 cm to 10.9 cm was associated with 39.7% cesarean section, 11 cm to 11.9 cm was associated with 18.9% cesarean section, more than or equal to 12 cm was associated with 10% cesarean section.…”

Width of pubic symphysis relating to age and sex in Koreans

“…Comparing the bony pelvis of European American women (EA) and Korean women (Kor) from the literatures [ 13 , 14 ], European women have larger interspinous distance (EA: 104±9 mm, Kor: 94.0±7.2 mm, p< 0.001) and intertuberous distance (EA: 133.5±9.6 mm, Kor: 97.7±10.1 mm, p< 0.001) than Koreans. From this, it is thought that the wider pubic symphysis in German women than Korean women is due to the larger pelvis size of Germans.…”

Khảo Sát Kích Thước Khung Chậu Ở Phụ Nữ Việt Nam Trưởng Thành Bằng Chụp Cắt Lớp Vi Tính

“…Mẫu nghiên cứu thu được 257 trường hợp, có cỡ mẫu lớn hơn một số nghiên cứu nước ngoài như nghiên cứu của Ismail Salk (2016) [3], C.Capelle(2020) [4], Lenhard (2009) [5], Sa Jin Kim (2011) [6], M.-H.Sigmann (2014) [7]. Tuy nhiên nghiên cứu của chúng tôi có cỡ mẫu nhỏ hơn so với Vázquez Barragán (2016) [8].…”

“…Trong nghiên cứu của Ismail Salk (2016), có 203 trường hợp được chia thành hai nhóm > 150 cm và ≤ 150 cm, tỉ lệ giữa nhóm > 150 cm và nhóm ≤ 150 cm xấp xỉ 4,49 lần. Kết quả nghiên cứu của chúng tôi cho thấy các đường kính khung chậu nữ có kích thước tương tự với kết quả của tác giả Ismail Salk (2016) [3], C.Capelle (2020) [4], Lenhard (2009) [5], Sa Jin Kim (2011) [6], M.-H. Sigmann (2014) [7] và Vázquez Barragán [8].…”