J Korean Soc Matern Child Health.  2022 Oct;26(4):283-288. 10.21896/jksmch.2022.26.4.283.

Association Between Female Bony Pelvimetry Using Magnetic Resonance Imaging and Cesarean Delivery due to Cephalopelvic Disproportion

• Na ED
• Baek MJ
• Moon JH
• Lee SM
• Lee H
• Yoon J
• Jung SH
• Jang JH
• Lee JY

• KMID: 2535918
• DOI: http://doi.org/10.21896/jksmch.2022.26.4.283

Abstract

Purpose
To analyze the difference in bony pelvimetry using magnetic resonance imaging (MRI) in women who delivered vaginally and those who underwent cesarean section (CS) due to cephalopelvic disproportion (CPD).
Methods
This retrospective case-control study enrolled Korean women who gave birth to their first child between 37 and 42 weeks of pregnancy and underwent pelvic MRI between January 2014 and June 2020. These women were classified into 3 groups: vaginal delivery (VD), CS due to CPD (CPD-CS), and CS due to reasons other than CPD (Other-CS). In MRI images, true conjugate (TC), obstetric conjugate (OC), mid anterior-posterior (AP) distance (MAD), outlet AP distance (OAD), ischial spine distance (ISD), ischial tuberosity distance (ITD), and pubic angle (PA) were measured.
Results
In total, 392 women were enrolled. There were no significant differences in maternal height and body mass index at birth among the 3 groups. The ISD was statistically different between the VD group (106.2±6.4 mm) and the Other-CS group (110.4±8.8 mm) (p=0.014). After multiple regression analysis, short ISD (adjusted odds ratio [aOR], 0.92; 95% confidence interval [CI], 0.87-0.97; p=0.002), short MAD (aOR, 0.95; 95% CI, 0.89-0.99; p=0.047), and short ITD (aOR, 0.95; 95% CI, 0.91-0.99; p=0.019) were significantly associated with CS due to CPD.
Conclusion
Short ISD, MAD, and ITD, measured using MRI, are important parameters that can predict CS due to CPD. The accumulation of related research could promote the development of an excellent imaging method in terms of cost-effectiveness. Thus, it may be possible to establish a method to reduce obstetric and perinatal complications due to dystonia.

Keyword

Cephalopelvic disproportion; Bony pelvimetry; Vaginal delivery; Cesarean delivery

Figure

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  Fig. 1. Pelvimetry measured using magnetic resonance imaging. (A) Sagittal view of the female pelvis: (a) true conjugate, (b) obstetric conjugate, (c) mid anterior-posterior distance, and (d) outlet anterior-posterior distance. (B) Ischial spine distance from the axial view. (C) Ischial tuberosity distance from the axial view. (D) Pubic angle from the axial view.

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