Abstract
In recent years, there has been a renewed interest in internal and external pelvimetry, in relation to the diagnosis of dystocia from a "contracted pelvis." Dystocia is still one of the causes of maternal-fetal morbidity and mortality in the world. The main cause is the fetal-pelvic disproportion, of which mechanical dystocia and contracted pelvis are most probably involved. Clinical pelvimetry was the diagnostic method of "contracted pelvis" and still seems to have its place in the clinical obstetric routine. Studies have been conducted in order to measure anatomical diameters and correlate them with operative or vaginal delivery. Some studies have been published regarding the diameters' variation with the shifting of the patient's posture. The positions used in the research for the analysis of changes in pelvis measurements are the same as those used for centuries to assist and promote childbirth.This technical report is to define a method of measuring changes in classical pelvimetric external diameters in relation to the postural change of the subjects, taking into consideration the needs of the operators, the postural difficulties of pregnant women and the evidence acquired from instrumental research. It aims to propose a dynamic postural method suited to daily practice, according to the directives and principles of the classical external obstetric pelvimetry.
Highlights
Dystocia is still one of the causes of maternal-fetal morbidity and mortality in the world and is often associated with fetal distress and operative delivery
Some studies have been published regarding the change of the pelvic diameters with the shifting of the patient's posture: the positions used in the research to analyze changes in pelvis measurements are the same as those used for centuries to assist and promote childbirth [5,6,7]
No technical report has been published so far to define the criteria of a method for measuring the external diameters of obstetrics pelvimetry with the postural change of the subjects, based on evidence acquired by instrumental researches and clinical practice, taking into account the needs of the operators and the difficulties during the movements of pregnant women
Summary
Dystocia is still one of the causes of maternal-fetal morbidity and mortality in the world and is often associated with fetal distress and operative delivery. No technical report has been published so far to define the criteria of a method for measuring the external diameters of obstetrics pelvimetry with the postural change of the subjects, based on evidence acquired by instrumental researches and clinical practice, taking into account the needs of the operators and the difficulties during the movements of pregnant women. The iliac inter-crestal diameter (Figure 2F) is the maximum distance between the lateral margins of the right and left iliac crests measured on the middle axillary line, at the point of their greatest width It is the upper limit of the region of the iliac fossae (false pelvis). The instruments used for the measurement of the external diameters of the pelvis are the Collin pelvimeter and the "bone-meter kit" (BMK) (Metrica SpA, Milan, Italy). Lower row (F-I): external pelvic diameters evaluated by Collin's pelvimeter
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