Diagnosis of cephalopelvic disproportion by evaluating three-dimensional pelvimetry and the fetal head.
スポンサーリンク
概要
- 論文の詳細を見る
Cephalopelvic disproportion (CPD) is defined as dystocia due to a disproportion between the maternal pelvis and the fetal head. However, definite diagnostic criteria of CPD have not been clearly defined.<BR>In this study, X-ray pelvimetry and ultrasonographic measurement of the size of the fetal head and abdomen were analyzed by three-dimensional imaging in 187 cases suspected of CPD at term. The minimum plane of the pelvic inlet (minInP) was used to calculate the area of the minimum pelvic inlet (minPA) and circumference of the minimum pelvic inlet (minPC). The head area (HA) and head circumference (HC) on the plane of the fetal biparietal diameter were also measured. To provide a reliable criterion for CPD, the minInP was compared with fetal head measurements.<BR>(1) Comparing the diameter of the maternal pelvis and the diameter of the fetal head showed a low sensitivity for predicting CPD.<BR>(2) There was a very high sensitivity and specificity in predicting CPD by comparing the area and circumference of minInP with those of the fetal head, showing a total sum of 180-185 % and positive predictive value of 63-77 % in patients with an area difference (minPA-HA) under 12cm<SUP>2</SUP> and the circumference difference (minPC-HC) under 2cm.<BR>(3) In 13 patients with less than 5cm<SUP>2</SUP> of minPA-HA, vaginal delivery was impossible. In 9 patients who had the area between 5 and 8cm<SUP>2</SUP> of minPA-HA, the incidence of CPD was 78 %. In 32 patients who had the area between 8 and 15cm<SUP>2</SUP> of minPA HA, the incidence of CPD was 25 %. But, in 133 patients showing over 15cm<SUP>2</SUP> difference between the areas, the incidence of CPD was 1 %.<BR>(4) In 9 patients with less than 0.5 cm of difference between minPC and HC, vaginal delivery was impossible. In 14 patients who showed between 0.5 and 1.5 cm difference in minPC-HC, the incidence of CPD was 86 %. In 44 patients who showed between 1.5 and 3.0 cm difference in minPC-HC, the incidence of CPD was 18 %. However, among 120 patients with more than 3cm difference between the circumferences, there was no case of CPD.<BR>These results suggested that minPA-HA and minPC-HC were useful diagnostic parameters during labor. [Adv Obster Gynecol 47(1) : 20-33, 1995 (H7.1)]
- 近畿産科婦人科学会の論文
近畿産科婦人科学会 | 論文
- 当院における卵巣粘液性腺癌の治療経験の検討
- 婦人科癌末期の難治性イレウスに対する減圧目的の経皮的内視鏡的胃瘻造設について
- 子宮体癌の保存的治療後妊娠での前置癒着胎盤に対し内腸骨動脈バルーン留置下で帝王切開および子宮全摘術を施行した1例
- 当科の卵巣粘液性腺癌の治療成績 : ─リンパ節郭清の適応についての考察
- 妊娠糖尿病を合併した高度肥満妊婦の分娩誘発の1例