Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
J Matern Fetal Neonatal Med. 2023 Dec;36(1):2190444. doi: 10.1080/14767058.2023.2190444.
While a basic understanding of pelvic size and typology is still important for obstetricians, pelvic measurement data for Japanese women are very scarce. To our best knowledge, no large-scale pelvimetry studies of Japanese women have been made for the past 50 years. This study aimed to investigate the accurate size, particularly the obstetric conjugate (OC) and transverse diameter of the pelvic inlet (TD), of modern Japanese women, using three-dimensional (3D) computed tomography (CT), and to obtain their reference values.
This retrospective, single-center observational study enrolled Japanese non-pregnant women aged between 20 and 40 years, who underwent pelvic CT examination from 2016 to 2021. CT was performed for various reasons, including acute abdomen, search for cancer metastases, and follow-up of existing disease. However, no cases were taken for pelvic measurements. Pelvimetry was performed retrospectively using a 3D workstation. The OC was measured on a strict lateral view and the TD was measured on an axial-oblique view. Other clinical data, such as age, height, and weight, were also extracted from the medical charts and analyzed.
A total of 1,263 patients were enrolled, with the mean age of 32.7 years (standard deviation [SD] 6.2). The mean height, weight, and body mass index were 158.8 cm (SD 5.8), 54.8 kg (SD 11.7), and 21.7 kg/m (SD 4.4), respectively. The mean OC length was 127.0 mm (SD 9.5, 95% confidence interval [CI] 126.5-127.5), while the mean TD length was 126.8 mm (SD 7.5, 95% CI 126.4-127.2). Both values were normally distributed. Height was significantly associated with OC (regression coefficient = 0.75 [95% CI 0.66-0.84], < .001) and TD (regression coefficient = 0.63 [95% CI 0.56-0.70], < .001). Age showed a weak but statistically significant positive association with TD (regression coefficient = 0.14 [95% CI 0.07-0.20], < .001) and OC (regression coefficient = -0.10 [95% CI -0.18 to -0.01], = .026).
The 3D CT pelvimetry in 1,263 non-pregnant Japanese women of childbearing age revealed the mean OC and TD of 127.0 mm, and 126.8 mm, which were 11.8 mm and 4.3 mm larger, respectively, than those in the survey in 1972. Our data will be referred to in clinical practice as the standard pelvic measurement values for the Japanese population.
尽管产科医生仍需要基本了解骨盆的大小和类型，但日本女性的骨盆测量数据非常匮乏。据我们所知，过去 50 年来，日本女性的大规模骨盆测量研究寥寥无几。本研究旨在通过三维（3D）计算机断层扫描（CT）研究现代日本女性的准确骨盆大小，特别是产科入口的坐骨棘间径（OC）和横径（TD），并获得其参考值。
这是一项回顾性、单中心观察性研究，纳入了 2016 年至 2021 年间因急性腹痛、寻找癌症转移灶或现有疾病随访而接受骨盆 CT 检查的 20-40 岁非妊娠日本女性。但没有因骨盆测量而进行 CT 检查的病例。使用 3D 工作站进行回顾性骨盆测量。OC 在严格的侧位上测量，TD 在轴向斜位上测量。还从病历中提取了其他临床数据，如年龄、身高和体重，并进行了分析。
共纳入 1263 例患者，平均年龄为 32.7 岁（标准差 [SD] 6.2）。平均身高、体重和体重指数分别为 158.8cm（SD 5.8）、54.8kg（SD 11.7）和 21.7kg/m（SD 4.4）。OC 长度的平均值为 127.0mm（SD 9.5，95%置信区间 [CI] 126.5-127.5），TD 长度的平均值为 126.8mm（SD 7.5，95% CI 126.4-127.2）。这两个值均呈正态分布。身高与 OC（回归系数=0.75 [95% CI 0.66-0.84]， < .001）和 TD（回归系数=0.63 [95% CI 0.56-0.70]， < .001）显著相关。年龄与 TD（回归系数=0.14 [95% CI 0.07-0.20]， < .001）和 OC（回归系数=0.10 [95% CI -0.18 至 -0.01]， = .026）呈弱但具有统计学意义的正相关。
1263 例生育年龄的非妊娠日本女性的 3D CT 骨盆测量显示，OC 和 TD 的平均值分别为 127.0mm 和 126.8mm，分别比 1972 年调查时大 11.8mm 和 4.3mm。我们的数据将作为日本人群骨盆测量的标准值，在临床实践中参考。
