Wozniak Slawomir, Piatek Aleksandra, Kurc-Darak Bozena, Domagala Zygmunt, Paulsen Friedrich, Florjanski Jerzy
Division of Anatomy, Department of Human Morphology and Embryology, Wroclaw Medical University, Chalubinskiego 6a, 50-368 Wroclaw, Poland.
2nd Department and Clinic of Gynaecology and Obstetrics, Wroclaw Medical University, Borowska 213, 50-556 Wroclaw, Poland.
J Clin Med. 2025 Jun 1;14(11):3898. doi: 10.3390/jcm14113898.
: The pubic symphysis is formed by the fusion of the right and left pubic bones. The metrics, such as breadth, length, and depth, increase during pregnancy and can be measured and analyzed using standard sonography. Obstetricians require clear and consistent criteria for standard sonography evaluation. : Sonographic examinations were performed on a cohort of 225 pregnant women, aged between 23 and 41 years, as part of a prospective observational study. The parameters measured included pubic symphysis entry middle width, intertubercular distance, pubic symphysis width, and pubic symphysis depth. : The width of the pubic symphysis exhibited the greatest consistency, measuring between 2.2 and 11.3 mm, whereas the depth displayed the highest variability, ranging from 5.4 to 22.6 mm. The measurements most correlated with fetal weight included pubic symphysis entry width (6.5 ± 3.4 mm; ˂ 0.001), pubic symphysis width (6.4 ± 2.9 mm; ˂ 0.001), and depth (14.8 ± 4.8 mm; = 0.03). The intertubercular distance exhibited the strongest correlation with maternal age (15.1 ± 5.4 mm; = 0.03). In contrast, pubic symphysis entry width (6.4 ± 3.3 mm; = 0.02; 6.4 ± 3.4 mm; ˂ 0.001) and pubic symphysis width (6.3 ± 2.6 mm; = 0.01; 6.3 ± 2.6; ˂ 0.001) demonstrated stronger associations with maternal weight and weight gained during pregnancy, respectively. In the singular pregnancy group, the width of the pubic symphysis exhibited significant correlations with fetal weight categories: under or equal to 1000 g (4.56 ± 1.5 mm; = 0.02), 1001-2000 g (5.51 ± 2.6 mm; = 0.02), and more than 3000 g (7.3 ± 3.9 mm; = 0.02). Pubic symphysis entry width is significantly correlated with fetal weight in the range of 1001-2000 g (5.5 ± 3 mm; = 0.02) and fetal weight exceeding 3000 g (7.4 ± 3.9 mm; = 0.02). In singular pregnancies, statistically significant differences were noted in intertubercular distance (15.9 ± 7.2 mm vs. 13.4 ± 6.2 mm; = 0.03) when comparing fetuses weighing 2000 g or less between nulliparous and multiparous women. : Fetal and maternal weight were the primary parameters that were positively correlated with these measurements. The term 'pubic symphysis entry' is proposed to describe a trapezoidal space situated superior to the pubic symphysis disc, delineated by an imaginary line connecting the bilateral pubic tubercles.
耻骨联合由左右耻骨融合而成。其各项指标,如宽度、长度和深度,在孕期会增加,可通过标准超声检查进行测量和分析。产科医生需要清晰且一致的标准来进行超声检查评估。
作为一项前瞻性观察性研究的一部分,对225名年龄在23至41岁之间的孕妇进行了超声检查。测量的参数包括耻骨联合入口中间宽度、结节间距离、耻骨联合宽度和耻骨联合深度。
耻骨联合宽度的一致性最高,测量值在2.2至11.3毫米之间,而深度的变异性最大,范围为5.4至22.6毫米。与胎儿体重最相关的测量值包括耻骨联合入口宽度(6.5±3.4毫米;<0.001)、耻骨联合宽度(6.4±2.9毫米;<0.001)和深度(14.8±4.8毫米;=0.03)。结节间距离与产妇年龄的相关性最强(15.1±5.4毫米;=0.03)。相比之下,耻骨联合入口宽度(6.4±3.3毫米;=0.02;6.4±3.4毫米;<0.001)和耻骨联合宽度(6.3±2.6毫米;=0.01;6.3±2.6;<0.001)分别与产妇体重和孕期体重增加有更强的关联。在单胎妊娠组中,耻骨联合宽度与胎儿体重类别存在显著相关性:小于或等于1000克(4.56±1.5毫米;=0.02)、1001 - 2000克(5.51±2.6毫米;=0.02)以及超过3000克(7.3±3.9毫米;=0.02)。耻骨联合入口宽度在1001 - 2000克(5.5±3毫米;=0.02)和超过3000克(7.4±3.9毫米;=0.02)的胎儿体重范围内与胎儿体重显著相关。在单胎妊娠中,比较初产妇和经产妇体重2000克或以下的胎儿时,结节间距离存在统计学显著差异(15.9±7.2毫米对13.4±6.2毫米;=0.03)。
胎儿和产妇体重是与这些测量值呈正相关的主要参数。提出术语“耻骨联合入口”来描述位于耻骨联合盘上方的梯形空间,该空间由连接双侧耻骨结节的假想线划定。