Document Detail


Postpartum X-ray pelvimetry. Its use in calculating the fetal-pelvic index and predicting fetal-pelvic disproportion.
MedLine Citation:
PMID:  12418069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether postpartum x-ray pelvimetry can be used to calculate the fetal-pelvic index (FPI) in future pregnancies. STUDY DESIGN: In stage I of the study, 10 gravid women, after 36 completed weeks' gestation, underwent x-ray pelvimetry before delivery. Pelvimetry was repeated within two days after delivery. Comparisons between antepartum and postpartum measurements were made using paired t tests and correlation coefficients. In stage II, 25 gravid women, after 36 completed weeks' gestation, underwent fetal ultrasound for biometry. X-ray pelvimetry was performed within two days after delivery. FPI was calculated for each pregnancy using antepartum fetal ultrasound and postpartum pelvimetry measurements. FPI calculations were correlated with the incidence of fetal-pelvic disproportion (FPD), as indicated by the requirement for cesarean section for arrest of active labor. Sensitivity, specificity and predictive value of FPI were assessed. RESULTS: In stage I, mean anteroposterior and transverse diameters of the pelvic inlet, midpelvis and pelvic outlet did not differ significantly. In stage II, the sensitivity of FPI for detecting FPD was 100%, specificity 95%, positive predictive value 80%, and negative predictive value 100%. CONCLUSION: Postpartum pelvimetry has the same association with FPD as antepartum pelvimetry. The strategy of using postpartum pelvimetry and antepartum fetal biometry to calculate FPI successfully identified 100% of the patients who ultimately required cesarean section for FPD, with a false positive rate of 5%. Pelvimetry performed postpartum in an index pregnancy may be used in future pregnancies, in combination with antepartum fetal ultrasound, to calculate FPI and predict the likelihood of FPD.
Authors:
Karen O'Brien; Martha Rode; George Macones
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  47     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-11-06     Completed Date:  2003-02-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  845-8     Citation Subset:  IM    
Affiliation:
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, 101 Dudley Street, Providence, RI 02905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Birth Weight
Cephalometry / methods*
Cesarean Section / statistics & numerical data
False Positive Reactions
Female
Gravidity
Humans
Incidence
Obstetric Labor Complications / diagnosis*,  epidemiology,  etiology,  therapy
Pelvimetry / methods*
Postnatal Care / methods*
Postpartum Period*
Predictive Value of Tests
Pregnancy
Pregnancy Trimester, Third
Prenatal Care / methods*
Prospective Studies
Ultrasonography, Prenatal / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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