The Diagnostic Accuracy of Clinical Pelvimetry in Identifying Small Pelvis in Nulliparous Women

Background Normal morphological features and size of the maternal pelvis are important prerequisitesto vaginal delivery. Advanced methods of pelvimetry are expensive and not widely available in developing countries. Clinical pelvimetry is aninexpensivemethod of assessing the pelvic capacity and is widelyused.The objective of this study was to determine the diagnostic accuracy of clinical pelvimetryinidentifying small pelvis in nulliparous women.Methods: In this double blind prospective analytical study between December 2008 and June 2009 527 nulliparous women who referred to the Ommolbanin hospital of Mashhad, entered the study. Clinical pelvimetrywas performedat the admission and the capacity of pelvic inlet, mid-pelvis and pelvic outlet were Data were analyzed bySPSS 11.5 software and fisher exact test andChi- square test were use for comparison ofpelvic capacity in the two groups.Results: Flat sacrum(p=0/003), Ischialspine distance less than 10cm(p=0/000), convergent pelvic wall(p=0/000), the pupic arc size less than 2 fingers (p=0/000)andthedistance between the ischial tuberositiesless than 9 cm(p=0/000),were observed more in the dystocia group. The combination of inlet measurements had the best sensitivity(33/3%). The combination of outlet and the combination of mid-pelvic measurements had the lowest sensitivity(4.6%).Conclusion: Clinical pelvimetry is not an accurate method for indentifyingsmall pelvisin nulliparous women and trial of labor should not be put aside on the base of clinical pelvimetry results.

کلیدواژه ها:

Dystocia ، Clinical Pelvimetry ، Pelvimetry ، NulliparousWomen