Zafarbaksh Azam, Moraghebi Razieh, Danesh Shahraki Azar, Khanjani Somayeh, Farahbod Farinaz, Haghollahi Fedyeh
Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Vali-E - Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2025 Jul 21;14:58. doi: 10.4103/abr.abr_446_23. eCollection 2025.
Normal morphological features of the maternal pelvis are important prerequisites for vaginal delivery. Clinical pelvimetry and sonopelvimetry are inexpensive methods of assessing pelvic capacity. This study aims to determine the diagnostic accuracy of clinical pelvimetry and sonopelvimetry in predicting the mode of delivery in nulliparous women.
In this cross-sectional study, 210 nulliparous women who came for delivery were assessed regarding their clinical and trans-abdominal ultrasonographic pelvimetry characteristics. Parameters including sacral promontory, diagonal conjugate diameter, curvature of the sacrum, interspinous diameter, side walls, sacrosciatic notch, and sub-pubic arch, prominence of coccyx, and intertubberous diameter were evaluated through clinical pelvimetry. Sonopelvimetry was performed to determine diagonal conjugate diameter. The measurements were compared between those who delivered through the vaginal route versus cesarean section (C/S). The receiver operating curve was depicted to determine the value of pelvimetry to prognosticate delivery mode.
Sacral promontory, diagonal conjugate diameter, curvature of the sacrum, interspinous diameter, side walls, sacrosciatic notch, sub-pubic arch, prominence of coccyx, and inter tuberous diameter were insignificantly different between those who delivered through the vaginal route versus C/S ( > 0.05). The mean diagonal conjugate diameter in ultrasonography assessments was 119.29 ± 7.80 mm in those undergoing C/S versus 120.12 ± 8.72 mm for NVD ones ( value = 0.659). None of the pelvic inlet, mid-pelvic, and outlet parameters could statistically predict the probability of CPD ( value > 0.05).
Based on the findings of this study, neither clinical pelvimetric parameters nor trans-abdominal ultrasonography could appropriately prognosticate delivery appropriateness through the vaginal route.
产妇骨盆的正常形态特征是阴道分娩的重要前提。临床骨盆测量和超声骨盆测量是评估骨盆容量的廉价方法。本研究旨在确定临床骨盆测量和超声骨盆测量在预测初产妇分娩方式方面的诊断准确性。
在这项横断面研究中，对210名前来分娩的初产妇的临床和经腹超声骨盆测量特征进行了评估。通过临床骨盆测量评估包括骶岬、对角径、骶骨曲率、棘间径、侧壁、骶坐骨切迹、耻骨弓、尾骨突出和坐骨结节间径等参数。进行超声骨盆测量以确定对角径。比较经阴道分娩与剖宫产（C/S）的测量值。绘制受试者操作曲线以确定骨盆测量对预测分娩方式的价值。
经阴道分娩与剖宫产的产妇在骶岬、对角径、骶骨曲率、棘间径、侧壁、骶坐骨切迹、耻骨弓、尾骨突出和坐骨结节间径方面无显著差异（>0.05）。剖宫产产妇超声评估的平均对角径为119.29±7.80mm，自然阴道分娩者为120.12±8.72mm（P值=0.659）。骨盆入口、中骨盆和出口的参数均不能统计学上预测头盆不称的可能性（P值>0.05）。
基于本研究的结果，临床骨盆测量参数和经腹超声均不能适当地预测经阴道分娩的适宜性。
