True Conjugate Research Articles

Association Between Female Bony Pelvimetry Using Magnetic Resonance Imaging and Cesarean Delivery due to Cephalopelvic Disproportion

Purpose: To analyze the difference in bony pelvimetry using magnetic resonance imaging (MRI) in women who delivered vaginally and those who underwent cesarean section (CS) due to cephalopelvic disproportion (CPD).Methods: This retrospective case-control study enrolled Korean women who gave birth to their first child between 37 and 42 weeks of pregnancy and underwent pelvic MRI between January 2014 and June 2020. These women were classified into 3 groups: vaginal delivery (VD), CS due to CPD (CPD-CS), and CS due to reasons other than CPD (Other-CS). In MRI images, true conjugate (TC), obstetric conjugate (OC), mid anterior-posterior (AP) distance (MAD), outlet AP distance (OAD), ischial spine distance (ISD), ischial tuberosity distance (ITD), and pubic angle (PA) were measured.Results: In total, 392 women were enrolled. There were no significant differences in maternal height and body mass index at birth among the 3 groups. The ISD was statistically different between the VD group (106.2±6.4 mm) and the Other-CS group (110.4±8.8 mm) (p=0.014). After multiple regression analysis, short ISD (adjusted odds ratio [aOR], 0.92; 95% confidence interval [CI], 0.87-0.97; p=0.002), short MAD (aOR, 0.95; 95% CI, 0.89-0.99; p=0.047), and short ITD (aOR, 0.95; 95% CI, 0.91-0.99; p=0.019) were significantly associated with CS due to CPD.Conclusion: Short ISD, MAD, and ITD, measured using MRI, are important parameters that can predict CS due to CPD. The accumulation of related research could promote the development of an excellent imaging method in terms of cost-effectiveness. Thus, it may be possible to establish a method to reduce obstetric and perinatal complications due to dystonia.

Pelvimetria em cadelas S.R.D. (sem raça definida)

Pelviology means the study of the pelvis, a structure formed by bones, ligaments and muscles. One of the subjects of pelviology corresponds to pelvimetry, which deals with the measurement of pelvic measurements, and which has a close relationship with reproduction. This study aims to verify the correlation between some body parameters and pelvic measurements. We used 50 N.R.D. female canine cadavers, varying in age and size, from euthanasia or natural death from the HOVET and Veterinary Clinics of the cities of XXX. Initially the body length, body height, thoracic perimeter, and body weight parameters were measured. Then, the bony pelvis was removed from the cadaver, sectioning the spine at the level between the lumbar vertebrae 5 (L5) and 6 (L6) and the femur in its middle third. Immediately after this procedure, the excess soft tissue was removed. In pelvimetry the following diameters were measured: thigh bone; transverse; acetabular; lateral ischiatic; true conjugate and vertical. The following mean values and standard deviation were obtained: 1) Body parameters: body weight (Kg) - 8.40 ± 5.86; height (cm) – 35.50 ± 11.76; body length (cm) – 48.60 ± 13.48; and thoracic perimeter (cm) – 43.80 ± 14.24; and 2) Pelvic diameters (cm): thigh bone – 3.313 ± 0.830; transversal – 3.864 ± 0.900; acetabular – 4.326 ± 1.140; lateral ischiatic – 7.171 ± 2.140; true conjugate – 4.720 ± 1.270; and vertical – 4.697 ± 1.270. Finally, it was verified that there is a significant positive correlation between body parameters and pelvic diameters

Referenced by Centralbl. f. Gynaek., 1894

Morisam (Naples) gave a talk "On symphysiotomy". Symphysiotomy is undertaken to extract a live, full-term fetus, with narrow pelvis with a true conjugate in 6.7 - 8.8 cm, with the onset of labor in the period of opening the throat.

Возможности геометрического моделирования в снижении погрешности расчета истинной конъюгаты

Возможности геометрического моделирования в снижении погрешности расчета истинной конъюгаты

Observations and facts from rural medical practice. 1. To the question of the treatment of childbirth with a narrow pelvis (3 cases)

Protracted the 1st birth with the head end. The bladder is very distended with urine, which could not be released, since the squeezed urethra did not pass the catheter. True conjugate 81/2 s. (the author does not mention how the true conjugate was determined neither in this nor in the following cases, ref.). The child is dead. A dead macerated boy with pronounced traces of forceps on his head was removed by very energetic traction. "Postpartum course with mild fever and pain in the lower abdomen, but the postpartum woman recovered after 3 weeks."

Macrosomic Newborn Anthropometric Parameters and the Mode of Delivery

Macrosomia is defined as a newborn weighing 4000 g and above. Its incidence varies between 2% to 15% in recent publications. The morbidity and mortality are still high in Sub Saharan Africa. The mode of delivery of the macrosomic fetus remains a challenging moment in obstetrics even today. The objective of this study was to assess the relation between macrosomic newborn anthropometrics parameters and the mode of delivery. It was a descriptive cross-sectional study, conducted from November 4th, 2013 to June 4th, 2014. All macrosomic newborn defined as birth weight ≥ 4000 g taken at the moment of delivery were included. Those born through an elective caesarian section or dead before maternal admission were excluded, so were mothers with a true conjugate <10.5 cm. Newborn anthropometric data were assessed according to the mode of delivery and maternofetal outcome. We used X2 for statistical analysis. The incidence was high, 7.68% (77/1002). Many macrosomia contributing factors like maternal age, parity, obesity, previous delivery of the macrosomic baby and male newborn were frequent in the study population. Maternal and fetal complications were rare. The frequency of vaginal delivery was 71.4% and the mode of delivery was not related to newborn weight, but rather to a new parameter, the newborn length, and the cut-off point was a newborn length of 53 cm. Macrosomic baby measuring 53 cm and above were more likely to be born vaginally whereas a length less than 53 increased the frequency of delivery by caesarian section (P=0.0001).

Female pelvic dimensions relevant to labour process in a black Kenyan population

Introduction: Maternal pelvic dimensions are key to determining progress and outcome of labour. In addition, the size of the pelvis is a crucial reference point in attempting to predict cephalopelvic disproportion. There is paucity of data regarding pelvic dimensions amongst black Kenyan population despite the central significance of such data in local obstetrics practice. Methods: A cross-sectional study of 50 female pelvic osteology specimens was performed at the National Museums of Kenya, Nairobi. Data were collected using a structured study instrument and were analyzed using Statistical Pack age for Social Sciences version 21. Results: At the pelvic inlet, the true conjugate was 10.37 ± 1.02cm, the diagonal conjugate was 11.72 ± 1.07cm and the obstetric conjugate was 11.44 ± 0.78cm. The transverse diameter was 11.42 ± 0.96cm. In the mid-cavity, the anteroposterior diameter was 10.64 ± 1.00cm, while the interspinous diameter was 8.49 ± 0.92cm. At the outlet, the anteroposterior diameter was 9.66 ± 1.16cm, while the intertuberous diameter was 9.04 ± 0.92cm. The subpubic angle was 74.54 ± 9.72 degrees. The posterior depth was 9.95 ± 1.11cm, while the anterior depth was 3.24 ± 1.41 cm. Conclusion: The average pelvic dimensions in this population are smaller than what has been observed in other populations. Of significance is that some morphometric dimensions were ominously smaller than what has been implicated in cephalopelvic disproportion. Imaging and clinical studies would help shed more light on correlation of the dimensions and obstetric outcomes in black Kenyan population.

A self-adjoint decomposition of the radial momentum operator

With acceptance of the Dirac's observation that the canonical quantization entails using Cartesian coordinates, we examine the operator erPr rather than Pr itself and demonstrate that there is a decomposition of erPr into a difference of two self-adjoint but noncommutative operators, in which one is the total momentum and another is the transverse one. This study renders the operator Pr indirectly measurable and physically meaningful, offering an explanation of why the mean value of Pr over a quantum mechanical state makes sense and supporting Dirac's claim that Pr "is real and is the true momentum conjugate to r".

Quantitative assessment of new MRI-based measurements to differentiate low and high stages of pelvic organ prolapse using support vector machines.

The objective of this study was to quantitatively assess the ability of new MRI-based measurements to differentiate low and high stages of pelvic organ prolapse. New measurements representing pelvic structural characteristics are proposed and analyzed using support vector machines (SVM). This retrospective study used data from 207 women with different types and stages of prolapse. Their demographic information, clinical history, and dynamic MRI data were obtained from the database. New MRI measurements were extracted and analyzed based on these reference lines: pubococcygeal line (PCL), mid-pubic line (MPL), true conjugate line (TCL), obstetric conjugate line (OCL), and diagonal conjugate line (DCL). A classification model using SVM was designed to assess the impact of the features (variables) in classifying prolapse into low or high stage. The classification model using SVM can accurately identified anterior prolapse with very high accuracy (>0.90), and apical and posterior prolapse with good accuracy (0.80 - 0.90). Two newly proposed MRI-based features were found to be significant in the identification of anterior and posterior prolapse: the angle between TCL and MPL for anterior prolapse, and the angle between DCL and PCL for posterior prolapse. The overall accuracy of posterior prolapse identification increased from 47% to 80% when the newly proposed MRI-based features were taken into consideration. The proposed MRI-based measurements are effective in differentiating low and high stages of pelvic organ prolapse, particularly for posterior prolapse.

Evaluation of normal female Sudanese pelvic anatomy using Magnetic Resonance Imaging (MRI)

Purpose: This study aims to investigate the dimensions of the bony pelvis and soft tissue structures and to characterize the normal gynaecological appearance of single Sudanese females using magnetic resonance imaging (MRI). Design/methodology/approach: Seventy-two single females aged between 15 and 80 years were selected using Sagittal T 2 -weighted pelvic MRIs of 1.5 tesla. The determined variables were uterine cervix cranio-caudal, uterus length, pelvis outlet, pelvic cavity and true conjugate, linearly correlated with age. Signal intensity was used to characterize the normal pelvis structures. For the bladder, uterus endometrium, myometrium, cervix, vagina, adenexa, ovaries, Sagittal T 1 ,T 2 and Coronal T 2 -weighted images were used. Findings: There were significant differences in Sudanese results when compared with Afro-American groups. Originality/value: This study may contribute to obstetrics and gynaecology in the future.

The relationship between anthropometric measurements and the bony pelvis in African American and European American women

The bony pelvis anatomy is highly variable. This study aims to examine the relationship between anthropometric measurements and the size of the adult female bony pelvis. Three-dimensional points of all pertinent landmarks of 96 adult female bony pelvises were obtained and the true conjugate, interspinous distance, intertuberous distance, and pelvic inlet and outlet areas were calculated. The relationship between these measurements and height and multiple anthropometric measurements were evaluated using Pearson's correlation coefficient (r). Multiple anthropometric measurements were significantly correlated with the true conjugate and pelvic inlet and outlet areas, but not with the interspinous or intertuberous widths. Height had a greater correlation with pelvic areas than any other anthropometric measure considered, even after controlling for race. There were no significant differences in pelvic areas between races. Height and other anthropometric measurements were significantly correlated with the true conjugate and pelvic inlet and outlet areas.

Factors Affecting the Outcome of Extraperitoneal Laparoscopic Radical Prostatectomy: Pelvic Arch Interference and Depth of the Pelvic Cavity

PurposeTo determine the effect of pelvic arch interference and the depth of the pelvic cavity, as shown on preoperative magnetic resonance imaging (MRI), on the performance of extraperitoneal laparoscopic radical prostatectomy (ELRP).Materials and MethodsIn 115 patients, pelvic bone images were obtained at the time of prostate MRI before ELRP. In the reconstructed sagittal plane, we measured the true conjugate diameter, the obstetric conjugate diameter, the difference between the true and obstetric diameters, and the distance between the true conjugate and the prostate apex (pelvic depth). We analyzed which factors were associated with operative time (OT), estimated blood loss (EBL), and positive surgical margins (PSMs).ResultsThe difference between the true and obstetric conjugate diameters was 12.7±3.7 mm, and the pelvic depth was 59.9±6.0 mm. The OT, EBL, and the rate of PSMs were 260.1±91.1 minutes, 633.3±524.7 ml, and 19% (22/115), respectively. According to multiple linear regression analysis, predictors of a higher EBL included pelvic depth (3.0% higher per 1 mm increase in diameter difference, p=0.01) and prostate volume (1.5% higher per 1 cc increase in prostate volume, p=0.002). Factors associated with a longer OT were pelvic depth (p=0.04), serum prostate-specific antigen (p=0.04), prostate volume (p=0.02), and Gleason score (p=0.001). For PSMs, only pT2 was an independent factor.ConclusionsOur results suggest that the depth of the pelvic cavity and prostate volume may increase surgical difficulty in patients undergoing ELRP.

Compare the architectural differences in the bony pelvis of Korean women and their association with the mode of delivery by computed tomography

Methods This study was conducted on 175 women who underwent CT between March of 2006 and May of 2008. For making an objective assessment, one specialist in obsterics and gynecology measured the obstetrical conjugate, the true conjugate and the diagonal conjugate on the sagittal plane and the transverse diameter, the intertuberous diameter and the interspinous diameter on the coronal plane. The patients who underwent total hysterectomy or those who had a disease of the uterus were excluded from the current analysis.

Comparative Study Of Intra-Operative Pelvimetry With Calipers And X-Ray Pelvimetry

The pelvic measurement of patients who have had a caesarean section was done using Pelvic Calipers (intra-operative) and x-ray methods. In the former method, during Caesarean sections and after closure of the lower uterine segment incision, a pair of pelvic calipers was used to measure the true conjugate of the pelvis. In the other method and same subject, between the 5th and 7th post-operative days when the patient could stand up right, an erect lateral pelvimetry was done (if this was not done prior to delivery) and the true conjugate was measured independently by the radiologist. For those who had x-ray pelvimetry prior to delivery, the true conjugate was measured from the previous radiograph. The average age and height of the patients were 27.5yrs and 160cm respectively. Cephalo-pelvic disproportion was the indication for sixteen (42%) of the primary Caesarean sections. The mean true conjugate diameter of the pelvis (cm) obtained by intra-operative pelvimetry and x-ray pelvimetry were 10.80 (SD 1.28) and 10.90 (SD 1.27) respectively. The difference between the two values was not significant (t < 1.98). The values of true conjugate obtained by both methods showed the same variation with height, age and parity. Patients with cephalo-pelvic disproportion had statistically smaller true conjugate than others when assessed by both methods. There is a strong correlation between intra-operative use of calipers and x-ray method in the measurement of true conjugate. It is thus concluded that intra-operative pelvic measurements using a pair of pelvic calipers (which is a direct measurement) could replace x-ray measurements in assessing pelvic size. Keywords: Pelvic measurement, caesarean section, X-ray pelvimetry. Annals of Biomedical Science Vol. 4 (1) 2005: pp. 19-24

The Factor Affecting Radical Retropubic Prostatectomy: The Bony Pelvic Shape Imaged by Magnetic Resonance Imaging

Purpose: We investigated how the bony pelvic shape, as imaged by preoperative magnetic resonance imaging (MRI), affects radical retropubic prostatectomy (RRP). Materials and Methods: We investigated 27 patients who underwent radical prostatectomy between January 2004 and December 2006 in our hospital. We obtained images of their pelvic bone size on the sagittal plane by performing pelvic MRI. We measured the true conjugate diameter, the obstetric conjugate diameter and the difference between the former and the latter. In addition, we examined the age, body mass index (BMI), prostate-specific antigen (PSA), prostate volume, Gleason's score, pathologic stage, operative time, the estimated blood loss and the surgical margin involvement. We analyzed the factors that affected the estimated blood loss, operative time and surgical margin involvement by multiple linear regression analysis and multiple logistic regression analysis. Results: The mean age of the patients was 66.7±5.3 years, the true conjugate diameter and obsteric conjugate diameter were 105±8.9mm and 94.5±9.2 mm respectively, the difference of the diameters was 10.7±4.3mm, the BMI was 24.1±2.6kg/m, the PSA was 22.9±34.2ng/ml and the prostate volume was 33.7±14g. The estimated blood loss was 1,152.2±356.4cc, the operation time was 144.4±28.6 minutes and 8 patients had positive surgical margins. On the multiple linear regression analysis, the estimated blood loss increased 66cc in proportion to a 1mm difference between the true conjugate diameter and the obstetric conjugate diameter (p<0.001). The BMI was associated with the operative time on the multiple linear regression analysis (p=0.048). Conclusions: For patients with RRP, the BMI was associated with the operative time. The estimated blood loss increased in proportion to the difference between the true conjugate diameter and the obstetric conjugate diameter, as measured by pelvic MRI before operation. We suggest that the symphyseal surface variability can be the one of the factors that affects the degree of operative difficulty. (Korean J Urol 2008;49:320-324) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Caesarean section in a semi-rural hospital in Northern Namibia

BackgroundIncreasing caesarean sections rates (CSR) are a major public health concern and the prevention of the first caesarean section, which often leads to repeat operations, is an important issue. Analyzing caesarean sections can help to identify factors associated with variations in CSR and help to assess the quality of clinical care.MethodsIn a retrospective observational study, during a two year period, indications of 576 caesarean sections were analyzed using intra-operative internal pelvimetry and a record keeping system in a semi-rural hospital in Northern Namibia.ResultsMost caesarean sections were done for dystocia (34%) followed by repeat caesarean section (31%). The true conjugate (distance between the promontorium to mid pubic bone) was significantly smaller in these recurrent indication groups when compared to non recurrent indications.ConclusionIn this rural hospital the introduction of Delee Pelvimetry and a caesarean section record keeping system was found to be a simple and cheap method to analyse indications for caesarean sections, which may help in reducing unnecessary caesarean sections.

A Conjugate-Cyclic-Autocorrelation Projection-Based Algorithm for Signal Parameter Estimation

A new algorithm to estimate amplitude, delay, phase, and frequency offset of a received signal is presented. The frequency-offset estimation is performed by maximizing, with respect to the conjugate cycle frequency, the projection of the measured conjugate-cyclic-autocorrelation function of the received signal over the true conjugate second-order cyclic autocorrelation. It is shown that this estimator is mean-square consistent, for moderate values of the data-record length, outperforms a previously proposed frequency-offset estimator, and leads to mean-square consistent estimators of the remaining parameters.

The relation of the true conjugate to maternal height and obstetric performance in Ghanaians

The true conjugate was determined intraoperatively with a caliper in 114 Ghanaian women and was correlated with their height, obstetric performance and fetal dimensions. Those patients undergoing cesarean section for cephalopelvic disproportion (Group Ia) were found to have a significantly shorter mean true conjugate (9.54 cm ± 0.63 S.D.) and mean body height (152.68 cm ± 5.46 S.D.) and a smaller true conjugate — fetal biparietal diameter difference (10.93 mm) than those who had no cephalopelvic disproportion (Group Ib) and whose mean measurements were 10.61 cm ± 0.81 S.D., 157.20 cm ± 5.69 S.D. and 21.50 mm, respectively (P = 0.0001). Recommendations for appropriate referral of rural clinic patients and for selection of patients for repeat cesarean sections are based on the above findings.

Pelvic assessment and cephalo-pelvic disproportion in Central Tanzania

Among 201 primigravidae, pelvic assessment was analyzed prospectively during the third trimester to detect patients likely to suffer from cephalo-pelvic disproportion (CPD). If the sacral promontory (SP) was reached by the index finger (9.0–9.5 cm true conjugate) the pelvis was regarded as “suspect”. All patients who later developed CPD were in this group. Of the screened primigravidas, 22% were advised to deliver in the hospital. Pelvic assessment is an important screening tool during antenatal care to detect high-risk primigravidas.

A low-dose CT-pelvimetry.

The suitability of CT for pelvimetry was studied. For accurate measurement of the true conjugate and interspinous diameter, a lateral topogram and an axial CT slice were taken. The radiation dose was reduced from 1 mGy (in conventional system) to 0.1-0.2 mGy.