Wischnik A, Lehmann K J, Zahn K, Georgi M, Melchert F
Frauenklinik, Fakultät für Klinische Medizin Mannheim, Universität Heidelberg.
Z Geburtshilfe Perinatol. 1992 Mar-Apr;196(2):49-54.
An increasing proportion of obstetric operative procedures due to cephalopelvic disproportion gave raise to the question, whether there has been a change in pelvic anatomy during the past decades. In a retrospective evaluation of 467 computerized pelvic tomograms of patients aged between 18 and 88 years relevant parameters of pelvic proportion were determined. As these parameters are not subject to age-conditioned changes, the values may be viewed as representative for the time of patients' birth or fertility period respectively. Changes in pelvic anatomy turned out to be complex: The transverse elliptic shape of pelvic inlet changed into sagittal elliptic form, the pelvic midplane is contracted progressively, sacral concavity is reduced. Obviously, this obstetrically adverse development is influenced by the fact, that unfavourable pelvic conformation can be transmitted more intensively by the generous indication for cesarean section. This development is contrasted by the circumstance of fetal acceleration. Therefore, an increase in cephalopelvic disproportion has to be expected. For the sake of a safe obstetrical management in these situations the generous use of ante partum pelvimetric diagnosis seems to be advisable.
因头盆不称而进行的产科手术比例不断增加，这引发了一个问题，即在过去几十年中骨盆解剖结构是否发生了变化。对467例年龄在18至88岁之间患者的计算机骨盆断层扫描进行回顾性评估，确定了骨盆比例的相关参数。由于这些参数不受年龄条件变化的影响，这些值可分别视为代表患者出生时或生育期的情况。结果表明，骨盆解剖结构的变化很复杂：骨盆入口的横向椭圆形变为矢状椭圆形，骨盆中平面逐渐收缩，骶骨凹陷减小。显然，这种对产科不利的发展受到以下事实的影响，即剖宫产的广泛指征会更强烈地传递不利的骨盆形态。这种发展与胎儿加速的情况形成对比。因此，可以预期头盆不称会增加。为了在这些情况下进行安全的产科管理，在产前进行骨盆测量诊断似乎是可取的。
