Three-dimensional pelvimetry. X-ray pelvimetry measured by computer and a concept of the minimum pelvic inlet space.:X-ray pelvimetry measured by computer and a concept of the minimum pelvic inlet space
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Contracted pelvis has been defined by the Terminology Committee, Japan Society of Obstetrics and Gynecology (1981), but the criteria depend only on the diameters of the pelvic inlet with diameters. In case of the pelvic aperature angle of less than 90 degrees, a plane smaller than the pelvic inlet exists. Three -dimensional space of the pelvic inlet and midpelvis, therefore, should be considered on evaluation of the pelvis for CPD.<BR>In this study, X-ray pelvimetry with a computer was performed, in the 202 cases of CPD clinically suspected at term.<BR>The minimum plane of the pelvic inlet (minInP) was calculated.<BR>(1) The difference between the obstetrical conjugate and the anteroposterior diameter of the pelvic inlet was 0.8 ± 0.6cm.<BR>(2) The evaluation of the diameters of the contracted pelvis for CPD was low in sensitivity. However, calculation of the area less than 95cm<SUP>2</SUP> and the circumference under 35cm of minInP were very high in sensitivity and specificity for evaluating CPD, showing a sum total of 159% and positive predictive value of about 70%.<BR>(3) In 30 patients with a pelvic area of less than 95cm<SUP>2</SUP>, the incidence of CPD was 73%, and in 29 patients with a pelvic area between 95 and 100cm<SUP>2</SUP>, the incidence of CPD was 17%. But, in 131 patients with a pelvic area of more than 100cm<SUP>2</SUP>, the incidence of CPD was 4%.<BR>(4) In 28 patients with a pelvic circumference of under 35cm, the incidence of CPD was 68%, and in 35 patients with a circumference between 35 and 36cm, the incidence of CPD was 26%. But in 127 patients with a pelvic circumference of more than 36cm, the incidence of CPD was 3%.<BR>These result suggested that X-ray pelvimetry measured by computer was precise and the calculation of minInP was one of useful diagnostic parameters for trial of labor. [Adv Obster Gynecol 47(1) : 8-19, 1995 (H7.1)]
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