Skip to content
Research Article Open access CC BY 4.0

The Utility of Mid-Pelvic Dimensions Via Plain Radiography in Predicting Cesarean Delivery

Bello A., Usman J. D.

Asian Journal of Medicine and Health · pp. 102–114 · Published 29 Sep 2023

10.9734/ajmah/2023/v21i11924

Abstract

Introduction: Studies on the role of pelvimetry in predicting the mode of delivery have yielded mixed results. The aim of this study is to determine utility of the mid-pelvic measurement in predicting the mode of delivery in a cohort of women attempting vaginal delivery. Study Design and Methods: With this prospective cohort study, we evaluated the use of x-ray in predicting the delivery outcome of women attempting to deliver vaginally. Women were recruited before labor at >36 weeks gestational age and X-ray pelvimetry was performed after delivery.  The exposures of interest were mid pelvic measures including anteroposterior diameters, transverse diameters and circumferences. The outcome measures were whether the women delivered via vaginal route or had cesarean delivery. We estimated the distribution and calculated measures of central tendency and spread of each pelvic dimension. Area under the receiver-operating characteristics curve (AUC) was used to estimate the overall predictive ability for each pelvic dimension and the optimal cut-point was estimated using the method of Liu. Logistic regression analysis was used to identify independent predictors for mode of delivery. The Hosmer – Lemeshow goodness-of-fit test was used to estimate the overall fit while the AUC was used to estimate the overall prediction of the final model. Results: A total of 426 women met the inclusion criteria. The mean gestational age at delivery was 40 (±6.0) weeks and the majority were black parturient (62.6%0. A slight majority were nulliparous (52.1%). In all, 127 women (29.8%) were delivered by cesarean delivery. All the pelvic inlet and mid pelvic dimensions were approximately normally distributed. The AUC ranged from 0.62 to 0.86. While the pelvic inlet and mid pelvic diameters had equivalent AUC, the optimal cut-point of the mid pelvic anteroposterior diameter (10.8cm) had both higher sensitivity and specificity than the pelvic inlet anteroposterior diameter (10.2cm) (95% and 85% versus 90% and 80%, respectively). There was an inverse relationship between the mid pelvic anteroposterior diameter and mode of delivery by cesarean section, with a 100% risk among women with a diameter of 9cm or less. However, the multivariable model developed had an AUC of 0.90, indicating overall good and higher predictive ability than the mid-pelvic anteroposterior diameter alone. Conclusions: In this large cohort study, the mid pelvic anteroposterior diameter best predicted mode of delivery by cesarean section.

Pelvimetry vaginal delivery cesarean delivery

References (28)

  1. 1 The American Journal of Obstetrics and Gynecology 1920–1945 [DOI]
  2. 2 The World Health Report 2005 - Make Every Mother and Child Count [DOI]
  3. 3 THE SAFE MOTHERHOOD INITIATIVE: A CALL TO ACTION [DOI]
  4. 4 Obstetrics: Normal and Problem Pregnancies [DOI]
  5. 5 Diagnostic and Interventional Imaging [DOI]
  6. 6 There is an obstetrical dilemma: Misconceptions about the evolution of human childbirth and pelvic form [DOI]
  7. 7 MR Imaging Pelvimetry: A Useful Adjunct in the Treatment of Women at Risk for Dystocia? [DOI]
  8. 8 ESTIMATION OF PELVIC CAPACITY [DOI]
  9. 9 Radiographic measures of the mid pelvis to predict cesarean delivery [DOI]
  10. 10 Anthropometric measurements in the diagnosis of pelvic size: an analysis of maternal height and shoe size and computed tomography pelvimetric data [DOI]
  11. 11 The diagnostic accuracy of pelvic measurements: threshold values and fetal size [DOI]
  12. 12 MR Pelvimetry for Breech Presentation at Term– Interobserver Reliability, Incidental Findings and Reference Values [DOI]
  13. 13 The fetal-pelvic index has minimal utility in predicting fetal-pelvic disproportion [DOI]
  14. 14 Prediction of cesarean delivery using the fetal-pelvic index [DOI]
  15. 15 The Bony Pelvis and its Influence on Labour: A Radiological and Clinical Study of 500 Women [DOI]
  16. 16 Changing concepts of x-ray pelvimetry [DOI]
  17. 17 Has pelvimetry a role in current obstetric practice? [DOI]
  18. 18 Trial of labor after cesarean and contribution of pelvimetry in the prognosis of neonatal morbidity [DOI]
  19. 19 Antenatal clinical pelvimetry in primigravidae and outcome of labour
  20. 20 Radiopelvimetry after cesarean section.
  21. 21 Roentgenographic Pelvimetry in Single Vertex Pregnancies [DOI]
  22. 22 Vaginal birth after cesarean section: X-ray pelvimetry at term is informative [DOI]
  23. 23 Normal pelvic dimensions of Nigerian women in Ile Ife by computed tomographic pelvimetry [DOI]
  24. 24 PELVIC CONTRACTION IN BREECH PRESENTATION [DOI]
  25. 25 Clinical Value of X-Ray Pelvimetry [DOI]
  26. 26 THE UTILIZATION AND EFFICACY OF PELVIMETRY [DOI]
  27. 27 Can the fetal-pelvic index predict fetal-pelvic disproportion during vaginal breech delivery? [DOI]
  28. 28 Archives of Gynecology and Obstetrics [DOI]

Cited by 0

No indexed citations yet.

Related research

Article metrics

Real usage data collected on this platform.

0

Page views

0

PDF downloads

0

Outbound clicks

0

Citations

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

No views recorded yet.

Traffic sources

Referring site, by host.

No traffic recorded yet.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.