Department of Anatomy, Faculty of Medicine, University of Novi Sad, Serbia.
Institute of Functional and Clinical Anatomy, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany.
Ann Anat. 2022 Aug;243:151942. doi: 10.1016/j.aanat.2022.151942. Epub 2022 Apr 2.
In the medical literature several classifications of the pelvis according to its shape can be found. The most common classification distinguishes four general pelvis types: gynecoid, android, anthropoid and platypelloid. Natural childbirth may be significantly prolonged, difficult or even impossible if the pelvis shape is not in proportion to the size of the fetus. The objectives of our study were to calculate major diameters and conjugate diameters of the female bony pelvic ring and to determine the major pelvic types according to their shape. Based on the parameters obtained, we aimed to establish a relationship between some pelvic types and difficult childbirth.
The study was prospective in design and included 54 female subjects of various ages who had been referred for computed tomography of the pelvis, as part of the diagnosis of an underlying condition. In each patient, five most important parameters in two planes were measured and the pelvic type was determined by using the brim index and a special formula for android type. All measurements were performed using the Vue PACS v 12.1.6.1005 program. The description of the pelvic inlet was used to confirm all pelvic types. Data on previous births were taken from the questionnaire filled out by the subjects during the radiological examination.
Gynecoid pelvic type was the most common in our sample (28 pelvises - 52%), followed by platypelloid type (11 pelvises - 20%), anthropoid type (8 pelvises - 15%) and finally android type (7 pelvises - 13%). There was a statistically significant difference in the diameter bispinous length (p < 0.05) between the platypelloid and anthropoid pelvic types. Pathological degree of stenosis was present in seven pelvises (the first degree in six pelvises and the second degree in one pelvis). The frequency of cesarean section was 31.82% and this technique was most frequently used in the subjects with a gynecoid pelvic type. The duration of natural labor ranged from 4 to 18 h. There was no statistically significant difference in the duration of labor between subjects with different pelvic types.
Gynecoid pelvic type was present in more than half of our subjects. Although this type is considered ideal for labor, we have not established that it has a great influence on whether the labor will be performed naturally or by cesarean section, neither that it significantly affects the length of birth. The gross narrowing of the pelvic ring is present in non-gynecoid pelvic types. The data obtained will certainly be useful to the obstetrician when planning the labor and considering all the factors that may affect the course of birth.
在医学文献中，根据骨盆形状可以找到几种分类。最常见的分类将骨盆分为四种一般类型：女型、男型、类人猿型和扁平型。如果骨盆形状与胎儿大小不成比例，自然分娩可能会显著延长、困难甚至不可能。我们研究的目的是计算女性骨盆骨环的主要直径和对角直径，并根据形状确定主要骨盆类型。基于获得的参数，我们旨在确定某些骨盆类型与难产之间的关系。
本研究为前瞻性设计，包括 54 名不同年龄的女性受试者，因潜在疾病进行骨盆计算机断层扫描而被转诊。在每位患者中，在两个平面上测量五个最重要的参数，并使用边缘指数和男型的特殊公式确定骨盆类型。所有测量均使用 Vue PACS v 12.1.6.1005 程序进行。使用骨盆入口描述来确认所有骨盆类型。通过受试者在放射检查期间填写的问卷获取以前分娩的数据。
在我们的样本中，女型骨盆类型最为常见（28 个骨盆-52%），其次是扁平型（11 个骨盆-20%）、类人猿型（8 个骨盆-15%），最后是男型（7 个骨盆-13%）。扁平型和类人猿型骨盆的双棘突长度直径存在统计学差异（p<0.05）。七例存在病理性狭窄程度（六例为第一度，一例为第二度）。剖宫产率为 31.82%，这种技术在女型骨盆类型的受试者中最常使用。自然分娩的持续时间从 4 小时到 18 小时不等。不同骨盆类型的产妇分娩持续时间无统计学差异。
在我们的受试者中，超过一半的人有女型骨盆。尽管这种类型被认为是分娩的理想类型，但我们尚未确定它对分娩是否自然进行或通过剖宫产进行有很大影响，也没有确定它对分娩长度有显著影响。非女型骨盆的骨盆环有明显的粗窄。获得的数据对产科医生在计划分娩时肯定是有用的，并考虑到可能影响分娩过程的所有因素。
