China
Africa
Explore chapters and articles related to this topic
Cephalopelvic Disproportion and Contracted Pelvis
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
The landmarks are the highest point on the iliac crest, the anterior superior iliac spines, the posterior superior iliac spines, the ischial tuberosity, upper border of the pubic symphysis, the fifth lumbar spinous process, and the beginning of the intergluteal fold (representing the tip of the sacrum). The following clinical pelvimetry has been described.
Breech presentation
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Randall C. Floyd, Martin L. Gimovsky
Taken alone, the measurement of pelvic diameters is not capable of reliably directing management, especially for women in labor. Experience has shown that minimal pelvic inlet measurements of 11 cm in the anteroposterior diameter and 12 cm at the transverse of the inlet, coupled with 10 cm at the mid-pelvic plane of the intraspinous diameter, are consistent with a normal bony pelvis (10, 11, 12 rule) (31–33,42). These recommended measurements should be used as a starting point in considering the labor of an average-sized fetus at term. A clinical consideration of fetal size is obviously a major issue in deciding upon the appropriateness of a labor trial. It may be helpful for the attending obstetrician to review the pelvimetry directly. The use of the fetal head circumference obtained by ultrasonography in addition to the CT-derived pelvic inlet measurements has been evaluated as a more definitive guide to fetopelvic disproportion (43).
Reproductive system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Pelvimetry is the technique used to assess the internal diameters of the female pelvis (Figs 8.29a–c). There are three imaging methods: conventional radiography, MRI and CT. The method of choice depends largely on the availability of equipment and local protocols. However, conventional radiography is now rarely undertaken, and readers can find the procedure described in Clark’s Procedures in Diagnostic Imaging.
Age effects on radiation response: summary of a recent symposium and future perspectives
Published in International Journal of Radiation Biology, 2022
Mark P. Little, Alina V. Brenner, Eric J. Grant, Hiromi Sugiyama, Dale L. Preston, Ritsu Sakata, John Cologne, Raquel Velazquez-Kronen, Mai Utada, Kiyohiko Mabuchi, Kotaro Ozasa, John D. Olson, Gregory O. Dugan, Simonetta Pazzaglia, J. Mark Cline, Kimberly E. Applegate
Fetal cancer risk from radiation exposures at 14 days post-conception to birth is not considered dependent on fetal age, although evidence exists from animal studies of increased risk at later pregnancy stage. Most of the information from epidemiologic data comes from the Japanese in utero cohort (2463 individuals) and the OSCC, a large case-control follow-up study of people that were exposed in utero to pelvimetry radiographs (Stewart et al. 1956; Bithell and Stewart 1975), but there is also information from several groups receiving clinical diagnostic and environmental exposures (Wakeford and Bithell 2021; Little et al. 2022a, 2022b). Recent follow-up in the Japanese cohort demonstrated that females in late adulthood continue to have excess mortality risk for solid cancer, although males do not (Sugiyama et al. 2021). The comprehensive review by Wakeford and Bithell (Wakeford and Bithell 2021) of the in utero medical exposures concludes that radiation increased the risk of leukemia and most common childhood cancers. In the OSCC, they estimated the unadjusted excess relative risk of fatal cancer associated with medical diagnostic radiation to be about 1.4–1.5 (up to age 15 years). Similar relative risks were observed in a systematic review and meta-analysis of all published studies (Little et al. 2022b). The estimated pelvimetry doses (on average, 10 mGy) from many decades ago are similar to modern, and optimized, single pass CT scans of the abdomen. Therefore, there may be opportunities to understand fetal risks from epidemiological studies of pregnant women undergoing medical imaging.
Can maternal hormones play a significant role in delivery mode?
Published in Journal of Obstetrics and Gynaecology, 2022
Christina Pappa, Fani Gkrozou, Evangelos Dimitriou, Orestis Tsonis, Aikaterini Kitsouli, Dimitrios Varvarousis, Vasileios Xydis, Minas Paschopoulos, Panagiotis Kitsoulis
All women had clinical assessment and blood tests in three different stages, at first trimester between 10 and 12 weeks, at the time of admission before childbirth and intrapartum just before delivery. Initially, we documented woman’s age, weight, height and body mass index and the gestational age. We also noted the pelvic diameters with internal pelvimetry through vaginal examination, transabdominal and transvaginal ultrasound (Caldwell and Moloy 1933; Cunningham et al. 2010; Lenhard et al. 2010). At the end of the examination 10 mL of blood were collected through venipuncture to assess progesterone, oestradiol and relaxin. At the second stage of assessment, we recorded the gestational age and the Bishop score on admission and we performed a new clinical examination followed by ultrasonographic examination to reassess the foetal growth and identify any differences from the initial pelvimetry (Salomon et al. 2019; Drennan et al. 2008). Additionally, another 10 mL of maternal blood were collected (Salomon et al. 2019; Cohen and Friedman 2021). At the third stage, we repeated the clinical examination and assessment of the pelvis along with intrapartum ultrasonography and we collected 10 mL of maternal blood for analysis (Drennan et al. 2008; Aydin et al. 2016; Cohen and Friedman 2021). Foetal weight was documented after childbirth.
Comparing the pelvis of Tibetan and Chinese Han women in rural areas of China: two population-based studies using coarsened exact matching
Published in Journal of Obstetrics and Gynaecology, 2022
Xiaojing Fan, Zhongliang Zhou, Martyn Stewart, Duolao Wang, Xin Lan, Shaonong Dang, Hong Yan
The pelvic dimension including IS, IC, EC and TO was one method used for assessment of contracted pelvis. Whilst this method was easier to implement, it may ignore other parameters. Factors such as gestational weeks, fat thickness and the posture of women when measuring the distance of the two ischial tuberosity’s inside edge may affect the measurements of EC and TO (Laster 1974). Iida et al. suggested that the contracted pelvis should be defined by measures such as the area of the pelvis inlet and the sacral shape (Iida and Takahashi 1993). When standard obstetric measurements were taken and compared to four additional medieval skeletal samples from Sudan, and to modern American standards for the same obstetric dimensions, the Sudanese Kulubnarti pelvis was smaller in most dimensions (Sibley et al. 1992). Studies had illustrated that the accuracy of clinical evaluation of the pelvic outlet is lower than when compared to X-ray pelvimetry, and the parameters of lesser pelvises could be better measured by an ultrasonic (Floberg et al. 1986; Kramarskii and Krasin 1991). Therefore, further assessments of the pelvis of Tibetan women would be required and caution was needed when estimating or comparing the incidence of contracted pelvis in Tibetan women.