Diameter Of Pelvic Inlet Research Articles

Systemic investigation of pelvimetric profile in three strains of Deoni cattle

The present research work was designed to establish baseline data of the pelvimetric profile in Deoni Cattle. Deoni cattle (270) of three strains, i.e. Wannera, Balankya and Shevera were selected and divided into six age groups: Group I (12 to 24 months), II (25 to 36 months), III (37 to 48 months), IV (49 to 60 months), V (61 to 72 months) and VI (73 to 84 months) with 45 animals in each group. Body weight along with different pelvimetric parameters such as distance between two angles of haunch (A), distance between two ischial tuberosities (B), distance between level of croup and hip joint (C) and distance between tuber coxae and tuber ischia (D) were measured to determine the transverse and vertical diameter of pelvic inlet and outlet which were used to calculate pelvic area of inlet and outlet. The pelvic area values for both inlet and outlet showed highly significant differences within groups, but no significant difference was observed between the three strains of each group. From the results of the study, it can be concluded that the pelvic area of Deoni cattle increases with the age and it has significant positive correlation with the parity and body weight. Thus, pelvimetric profile can be used as a marker for selection of young Deoni heifers and cows for breeding purposes to lower dystocia incidences.

Could radiological parameters help to predict the failure of ureteral access sheath placement

To identify the radiological parameters which may help to predict the success of ureteral access sheath (UAS) placement during retrograde intrarenal surgery (RIRS).The study included 49 patients in whom failure ureteral access sheath placement in RIRS and 49 control group patients who were successfully placement between January 2023 and December 2023. The age, gender, body mass index (BMI), non-contrast computed tomography (NCCT), and kidney ureter bladder (KUB) radiographs were compared between the two groups. Measurements of the anteroposterior (ap) diameter of the pelvic inlet, anteroposterior diameter of the pelvic outlet, interspinous distance diameter were taken from non-contrast computed tomography (NCCT), while pelvic anteroposterior diameter and pelvic lateral diameter were measured from kidney ureter bladder (KUB) radiography. There were no significant differences between the groups in age, gender, body mass index, ap pelvic inlet diameter, ap pelvic outlet, and interspinous distance diameter. However, a statistically significant difference was found between the pelvic ap diameter and pelvic lateral diameter values measured on the KUB radiography. The values for pelvic ap diameter and pelvic lateral diameter measured in the KUB radiographs can be used to predict the likelihood of UAS passage during RIRC procedures. However, further studies with larger patient groups are needed to establish a cut-off value.

Anthropometric study using three-dimensional pelvic CT scan in sex determination among adult Indonesian population

This study aims to determine pelvic anthropometry characteristics and logistic regression formula for adult sex identification obtained from adult three-dimensional pelvic computed tomography images. This study was an observational analytical study with retrospective regression and cross-sectional approach. The population was all patients at Radiology Installation of Dr. Soetomo General Academic Hospital as referral hospital in East Indonesian region, from September to December 2019 who underwent 3D pelvic CT examination. Then, age distribution and pelvic measurements data were obtained. In this case, statistical analysis was conducted for all the data obtained. A number of 204 samples were included in this study. All radiologic components were also significantly different between sexes (p < 0.05) except for transverse diameter of sacral segment (p = 0.180). Moreover, the conjugate pelvic inlet diameter (CPID), the left innominate height (LIH), and sub pubic angle (SPA) showed significant values for regression formula to determine an adult’s sex using 3D pelvic CT. The calculation result > 0 is a prediction for female while < 0 is a prediction for male. From logistic regression model calculation, a high validity value (91.05%) was found with 100% sensitivity to identify male sex and 81.1% specificity to identify female sex. There were differences on radiometric variable characteristics in pelvic anthropometric study among adult Indonesians at Dr. Soetomo General Academic Hospital, Surabaya. The estimated values of pelvic measurements using 3D CT images could develop a pelvic model with a regression formula with high accuracy value using CPID, LIH, and SPA values.

Pelvimetry by Three-Dimensional Computed Tomography in Non-Pregnant Multiparous Women Who Delivered Vaginally

SummaryBackgroundWe assessed retrospectively the reference values of pelvic dimensions by 3D CT performed for non-obstetrical indications in non-pregnant multiparous women with a successful vaginal delivery. We further aimed to evaluate the impact of maternal short stature on these parameters.Material/MethodsThe 3D CT pelvimetry was performed retrospectively in 203 non-pregnant women selected consecutively if they had at least one singleton term delivery with head presentation and if there was no history of maternal or fetal birth trauma or cerebral palsy after childbirth. With standard sagittal and reformatted axial-oblique views, anteroposterior including three conjugates of pelvic inlet, transverse, posterior sagittal diameters of pelvic inlet, the plane of greatest diameter, the plane of least diameter, and pelvic outlet were measured. Selected obstetric parameters were collected.ResultsOverall, the pelvises had transverse oval appearance in inlet and size of the female pelvis. The diagonal conjugate was at least 15 mm longer than the obstetric conjugate. Women with short stature had lower maximal birth weight, and this was in accordance with their somewhat lower pelvic diameters.ConclusionsThe findings of this study present the reference values of the main planes of the true pelvis by 3D CT pelvimetry in a relatively large group of multiparous women who passed a trial of labor successfully. Overall, the pelvises had features of female pelvic bony structure although pelvic diameters were somewhat lower in multiparous women with short stature. The 3D pelvimetry with CT applications may be used as an adjunct to clinical and ultrasonographic examinations to rule out cephalopelvic dystocia in selected cases.

Intra- and Inter-Observer Reproducibility of Ultrasound Measurements of Pelvic Inlet Diameter in Pregnant Women

Objectives: To determine intra- and inter-observer reproducibility of the ultrasound measurement of pelvic inlet in the first trimester of pregnancy. Methods: Transabdominal pelvic ultrasound was performed to measure the pelvic inlet anteroposterior diameter using a 2D probe in twelve Chinese women having a singleton pregnancy. Scans were performed in the first trimester by three sonographers. The pelvic inlet anteroposterior diameter was defined as the distance between the anterior surfaces of the sacral promontory and the superior medial border of the pubic bone most adjacent to the pubic symphysis. Intra-observer repeatability was determined and analysis of variance was performed to assess inter-observer measurements. The bias between any two sonographers’ measurements was assessed by calculating the 95% confidence interval for the mean difference between sonographers paired measurements. Results: Intra-observer reproducibility was 0.71 cm. Analysis of variance indicated that there was no significant difference between sonographers’ measurements (p = 0.46). The bias between two sonographers’ measurements ranged from 0.05 to 0.32 cm. Conclusion: It is technically feasible to measure the pelvic inlet diameter using ultrasound (USG) at the first trimester. High inter-observer reproducibility can be achieved. Further studies are required to establish the potential role of this technique and the measurement of the pelvic inlet diameter in prediction of labor outcome.

Analysis of normal pelvis morphometry of modern Chinese southern Han female and its correlation with age

To analyze the normal pelvis morphometry of Chinese southern Han female and its correlation with age. From August 2009 to September 2011, 289 Han nationality females who received pelvis CT scan at Nanfang Hospital of Southern Medical University were eligible for the study. Their mean age was 43.5 years, with normal body development and no pelvic abnormality. The patients were divided into 3 age groups: 25 to 40 (n = 109), 41 to 50 (n = 115), and >50 years (n = 65). After constructing a three-dimensional digital model of the pelvis, the following parameters were measured, including transverse inlet diameter, posterior sagittal diameter of pelvic inlet, sagittal inlet, diagonal conjugate, biischial diameter, posterior sagittal diameter of midpelvis, sagittal midpelvic diameter, intertuberous distance, posterior sagittal diameter of outlet, angle of pubic arch, sagittal outlet, penal height, sacrum length and sacrum curvature. The relationship between all parameters and age was analyzed. (1) The posterior sagittal diameters of pelvic inlet of the 25 to 40 age group, 41 to 50 age group, >50 years age group were (53 ± 8), (51 ± 7), (48 ± 6) mm. The sagittal inlet of the three groups were (122 ± 8), (120 ± 9), (114 ± 8) mm. And the diagonal conjugate of the three groups were (135 ± 10), (132 ± 9), (127 ± 9) mm. All had significant differences among the three groups (P < 0.01) . (2) The posterior sagittal diameter of midpelvis of the three groups were (43 ± 6), (44 ± 6), (43 ± 7) mm, and the sagittal midpelvic diameter of the three groups were (119 ± 8), (120 ± 8), (119 ± 7) mm, with no significant difference among the three groups (P > 0.05). (3) The intertuberous distance of the three groups were (122 ± 11), (121 ± 10), (117 ± 11) mm, and the posterior sagittal diameter of outlet of the three groups were (56 ± 9), (58 ± 8), (57 ± 9) mm. There was no significant difference among the three groups (P > 0.05) .(4) Penal height of three groups were (31 ± 3), (33 ± 3), (34 ± 3) mm, there was with significant differences (P < 0.01) .(5) Pearson correlation analysis showed that penal height was positively correlated with age (r = 0.331, P < 0.05), while sagittal inlet, posterior sagittal diameter of inlet, diagonal conjugate, intertuberous distance, angle of pubic arch, sacrum length and sacrum curvature were negatively correlated with age (r = -0.120 to -0.343, P < 0.05). The shape of the pelvic inlet of Chinese southern Han female changed from sagittal elliptic into transverse elliptic form, and the posterior part of pelvic inlet became larger.Sacral concavity was increased and the pelvis became deeper. Mid pelvis and the pelvic outlet was almost unchanged, and showed no correlation with age.

Investigation of correlation between diameters of pelvic inlet and outlet planes and female pelvic floor dysfunction

ObjectiveTo investigate correlation between key diameters of pelvic inlet and outlet planes and female pelvic floor dysfunction (FPFD). Study designCorrelation with incidence of FPFD was analyzed by measuring the two diameters of pelvic inlet and outlet planes (i.e. anteroposterior diameter of pelvic inlet and transverse diameter of pelvic outlet) in 298 patients with FPFD and 508 patients in control group taking into account of other relevant factors. ResultsThe transverse diameter of pelvic outlet was significantly larger in experimental group than in control group (9.55cm vs. 8.50cm, P<0.01); while the difference in anteroposterior diameter of pelvic inlet between the two groups was not statistically significant (11.63cm vs. 11.26cm, P=0.205>0.01); Binary logistic regression analysis indicated that the anteroposterior diameter of pelvic inlet was not correlated with incidence of FPFD, but the transverse diameter of pelvic outlet was one of the influencing factor for FPFD. ConclusionsThe transverse diameter of pelvic outlet is closely correlated with incidence of FPFD and represents one of the risk factors for FPFD; a transverse diameter of pelvic outlet greater than 9.5cm is the threshold for onset of FPFD and can be used as an early predictive index for FPFD.

Evaluation of factors affecting the difficulty of laparoscopic anterior resection for rectal cancer: “narrow pelvis” is not a contraindication

This study aims to evaluate the clinical and anatomical factors, particularly pelvic dimensions that influence the difficulty of performing laparoscopic anterior resection for rectal cancer. We studied 50 consecutive patients who underwent laparoscopic anterior resection with double-stapling technique (DST) anastomosis for rectal cancer between January 2006 and February 2010. Staging was performed by computed tomography. Five pelvic dimensions (anteroposterior and transverse diameters of pelvic inlet and outlet, and pelvic depth) were measured using three-dimensional volume-rendering images. We also examined a number of other clinical characteristics, including gender, history of laparotomy, body mass index (BMI), operator, tumor location, tumor depth, nodal involvement, and tumor diameter. Univariate and multivariate analyses were performed to determine the predictive significance of these variables on surgical difficulty based on operative time and intraoperative blood loss. Males had significantly shorter pelvic inlets and outlets and significantly greater pelvic depth than females. However, gender did not significantly affect surgical outcomes, although males did tend to experience greater blood loss. Maximum tumor diameter (p=0.014), BMI (p=0.001), operator (p<0.001), and tumor location (p=0.009) were independent predictors of operative time, which, in turn, was related to intraoperative blood loss (p<0.001). Maximum tumor diameter, BMI, operator experience, and tumor location can be used to predict the operative time required to complete laparoscopic anterior resection with DST anastomosis for rectal cancer, with no correlations between pelvic dimensions and operative time. The difficulty of the procedure was not related to patients' pelvic dimensions, which led us to conclude that "narrow pelvis" is not a contraindication for this surgery. Based on these results, we suggest that laparoscopic anterior resection should be performed by experienced surgeons in patients with large tumors, high BMI, and/or extraperitoneal rectal cancer.

Pelvis Architecture and Urinary Incontinence in Women

ObjectivesTo examine anatomic features in the pelvic bones and muscles in women with urinary incontinence (UI). Material and methodsBetween October 2005 and January 2006, 212 consecutive women underwent pelvic computerized tomography in our center. Preceding the examination, all women completed a clinical and demographic questionnaire including detailed questions about UI. Several anatomic parameters using multiplanar reformation and three-dimensional techniques (volume rendering) were examined. We specifically evaluated different bony parameters, pelvic floor muscle angles, densities, and cross-sectional areas. Ninety-three women (46.5%) had UI; the remaining women served as the control group. A logistic regression model was used to evaluate risk factors for UI. ResultsThe mean age was 55.5 yr (range: 19–90). Women who suffered from UI were older (60.97 vs. 50.77 yr, p<0.0001), had higher body mass index (27.65 vs. 25.49, p<0.01), had more previous hysterectomies (21.5% vs. 6.5%, p<0.005), underwent more pelvic irradiation (9.7% vs. 1.8%, p<0.05), and had more diabetes mellitus (31.2% vs. 13.1%, p<0.005). Patient’s age and previous hysterectomy were found to be the major clinical risk factors for UI (OR: 1.029, p=0.002; OR: 2.94, p=0.024, respectively). Logistic regression analysis on all clinical and morphologic variables yielded the following risk factors: pelvic-inlet diameter (OR: 1.216, p<0.0001), pelvic-inlet anterior-posterior diameter (OR: 1.109, p=0.003), pelvic-outlet diameter (OR: 1.077, p=0.011) and transverse perineal muscle cross-section diameter (OR: 0.773, p<0.0001). ConclusionsPelvic inlet and outlet dimensions are major risk factors for developing UI in women. These findings may lead to a better comprehension of the pathophysiology of UI in women.

Three-dimensional computed tomography evaluation of bony birth canal morphologic deformity (small pelvic cavity) after dome pelvic osteotomy for developmental dysplasia of the hip

Objective: Using three-dimensional computed tomography, we investigated the morphologic deformity of the birth canal in patients with developmental dysplasia of the hip who underwent dome pelvic osteotomy. Study Design: Thirty-five normal subjects, 34 patients with developmental dysplasia of the hip who did not undergo dome pelvic osteotomy, and 21 patients with developmental dysplasia of the hip who underwent dome pelvic osteotomy were recruited for the study. We assessed the underlying pelvic deformities together with the postoperative pelvic morphologic changes (iatrogenic deformity). Results: Sagittal diameters of the pelvic contraction were longer, and transverse diameters of the pelvic inlet, expansion, and contraction were shorter in patients after dome pelvic osteotomy than in normal control subjects. Conclusion: Anthropoid-type pelvis (a long pelvic inlet diameter in the sagittal dimension while the corresponding measurement in the transverse dimension is short) was observed in as many as 90.5% of patients with developmental dysplasia of the hip after dome pelvic osteotomy. (Am J Obstet Gynecol 2002;187:1591-5.)

Pelvimetry with magnetic resonance tomography

Magnetic resonance imaging (MRI) in the mediosagittal and transverse planes was used to measure the antero-posterior and transverse diameters of the minor pelvic cavity. The measurements for the diameters were larger than those usually found in the literature. The antero-posterior pelvic inlet diameter, the most important measurement for obstetrics, was on average 11.9 cm in contrast to the generally accepted length of 11.0 cm.

Error introduced by patient rotation in lateral pelvmetry.

The degree of error in determining the sacro-pubic distance (antero-posterior diameter of pelvic inlet) when the patient is rotated depends on the shape of the pelvis. Greater degrees of rotation can be accepted in the anteriorly flat pelvis than in the pelvis which is more arcuate anteriorly. In the flat pelvis, the error with slight to moderate rotation (5–15 deg.) is minimal; in the elongated pelvis the error is greater but still small. When the patient is rotated the measured sacro-pubic dimension is almost always the same as (flat pelvis) or less than (rounded pelvis) the actual diameter on a true lateral film. Thus, there is no need to repeat the pelvimetry if the measurement on the rotated film is considered adequate clinically. A repeat would only show a sagittal diameter which is larger or the same as that on the rotated film. In the deformed pelvis, the error may be more variable. Precise calculation of the error introduced by a specific degree of rotation is impractical because of the great variety of pelvic shapes.

Radiologic pelvimetry with special reference to widest transverse diameter of pelvic inlet.

Radiologic pelvimetry with special reference to widest transverse diameter of pelvic inlet.