X-ray pelvimetry in a breech protocol: A comparison of digital radiography and conventional methods

Gimovsky, Martin L.; Willard, Kathleen; Neglio, Michael; Howard, Thora; Zerne, Stanley

doi:10.1016/0002-9378(85)90695-7

Cited by 23 publications

(3 citation statements)

References 7 publications

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“…Seven (35%) of 20 had the ischial spines below the foveae, with an average distance of 0.9 cm. Among patients who had the foveae and the ischial spines at different levels, axial measurements were available at both levels in 1 …”

Section: Resultsmentioning

confidence: 99%

CT pelvimetry: the foveae are not an accurate landmark for the level of the ischial spines.

Aronson

Kier²

1991

American Journal of Roentgenology

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The most important distance measured during CT pelvimetry is the interspinous diameter of the pelvis as seen on axial scans, because most cases of obstructed labor occur at the level of the ischial spines. As the spines are difficult to identify on the anteropostenor digital scout radiograph, the fovea of the femoral head has been used as a landmark to determine the level of the appropriate axial slice. We assessed the accuracy of this landmark on CT scans in 23 women undergoing CT pelvimetry and in 20 nonpregnant women having pelvic CT scans. In each case the relationship between the level of the foveae and the level of the ischial spines was determined. True interspinous distances were measured and compared with the apparent interspinous distances at the level of the foveae. In none of the women were the ischial spines above the foveae. In 15 (65%) of 23 pregnant women and in seven (35%) of 20 nonpregnant women, the ischial spines were below the foveae. An incorrect scanning level led to an overestimation of interspinous distance by an average of 1.0 cm. We conclude that for CT pelvimetry, the fovea as seen on the anteropostenor digital radiograph is an inaccurate landmark for the level of the ischial spines.

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Section: Resultsmentioning

confidence: 99%

CT pelvimetry: the foveae are not an accurate landmark for the level of the ischial spines.

Aronson

Kier²

1991

American Journal of Roentgenology

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“…Digital CT scan pelvimetry [5,11] uses anteroposterior and lateral CT scan scout radiographs to obtain digital measurements. CT has replaced conventional pelvimetry because of its ease, speed, and reduced radiation [7]. Six standard pelvimetry measurements were made: the anteroposterior and transverse diameters at the inlet, midpelvis, and outlet levels [3] as shown in Fig.…”

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confidence: 99%

Influence of pelvic osteotomy on birth canal size

Loder

Karol

Johnson

1993

Arch Orthop Trauma Surg

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Six pelvic osteotomies (Salter, Sutherland, Steel, Tönnis, Chiari, and periacetabular) were performed on the right hemipelvis of adult female pelvic plastic models. Each pelvis underwent conventional X-ray and computed tomographic digital pelvimetry before and after osteotomy. The change in the anteroposterior and transverse dimensions at the inlet, midpelvis, and outlet were calculated. None of the osteotomies significantly decreased the inlet. The Salter and Sutherland osteotomies decreased the midpelvis to borderline low. The Salter, Sutherland, and Steel osteotomies significantly decreased the pelvic outlet. These changes correlated closely with those in living patients. Much of this decrease is nullified when the osteotomy is performed prior to the pubertal growth spurt.

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“…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 …”

mentioning

confidence: 99%

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

Kim

Lee

et al. 2011

Korean J Obstet Gynecol

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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

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X-ray pelvimetry in a breech protocol: A comparison of digital radiography and conventional methods

Cited by 23 publications

References 7 publications

CT pelvimetry: the foveae are not an accurate landmark for the level of the ischial spines.

CT pelvimetry: the foveae are not an accurate landmark for the level of the ischial spines.

Influence of pelvic osteotomy on birth canal size

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

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