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Nishikawa S, Miki M, Chigusa Y, Furuta M, Kido A, Kawamura Y, Ueda Y, Mandai M, Mogami H. Obstetric pelvimetry by three-dimensional computed tomography in non-pregnant Japanese women: a retrospective single-center study. J Matern Fetal Neonatal Med 2023; 36:2190444. [PMID: 36927362 DOI: 10.1080/14767058.2023.2190444] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE While a basic understanding of pelvic size and typology is still important for obstetricians, pelvic measurement data for Japanese women are very scarce. To our best knowledge, no large-scale pelvimetry studies of Japanese women have been made for the past 50 years. This study aimed to investigate the accurate size, particularly the obstetric conjugate (OC) and transverse diameter of the pelvic inlet (TD), of modern Japanese women, using three-dimensional (3D) computed tomography (CT), and to obtain their reference values. METHODS This retrospective, single-center observational study enrolled Japanese non-pregnant women aged between 20 and 40 years, who underwent pelvic CT examination from 2016 to 2021. CT was performed for various reasons, including acute abdomen, search for cancer metastases, and follow-up of existing disease. However, no cases were taken for pelvic measurements. Pelvimetry was performed retrospectively using a 3D workstation. The OC was measured on a strict lateral view and the TD was measured on an axial-oblique view. Other clinical data, such as age, height, and weight, were also extracted from the medical charts and analyzed. RESULTS A total of 1,263 patients were enrolled, with the mean age of 32.7 years (standard deviation [SD] 6.2). The mean height, weight, and body mass index were 158.8 cm (SD 5.8), 54.8 kg (SD 11.7), and 21.7 kg/m2 (SD 4.4), respectively. The mean OC length was 127.0 mm (SD 9.5, 95% confidence interval [CI] 126.5-127.5), while the mean TD length was 126.8 mm (SD 7.5, 95% CI 126.4-127.2). Both values were normally distributed. Height was significantly associated with OC (regression coefficient = 0.75 [95% CI 0.66-0.84], p < .001) and TD (regression coefficient = 0.63 [95% CI 0.56-0.70], p < .001). Age showed a weak but statistically significant positive association with TD (regression coefficient = 0.14 [95% CI 0.07-0.20], p < .001) and OC (regression coefficient = -0.10 [95% CI -0.18 to -0.01], p = .026). CONCLUSION The 3D CT pelvimetry in 1,263 non-pregnant Japanese women of childbearing age revealed the mean OC and TD of 127.0 mm, and 126.8 mm, which were 11.8 mm and 4.3 mm larger, respectively, than those in the survey in 1972. Our data will be referred to in clinical practice as the standard pelvic measurement values for the Japanese population.
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Affiliation(s)
- Shoko Nishikawa
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masayo Miki
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoshitsugu Chigusa
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Marie Furuta
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Aki Kido
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yosuke Kawamura
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Ueda
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masaki Mandai
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Haruta Mogami
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Ramirez Zegarra R, Dall'Asta A, di Pasquo E, Ghi T. Antepartum sonographic prediction of cephalopelvic disproportion: are we getting any closer? Am J Obstet Gynecol MFM 2023; 5:100828. [PMID: 36529655 DOI: 10.1016/j.ajogmf.2022.100828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/15/2022] [Accepted: 11/27/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Ruben Ramirez Zegarra
- Obstetrics and Gynecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Andrea Dall'Asta
- Obstetrics and Gynecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Elvira di Pasquo
- Obstetrics and Gynecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Tullio Ghi
- Obstetrics and Gynecology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
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Di Pasquo E, Morganelli G, Volpe N, Labadini C, Ramirez Zegarra R, Abou-Dakn M, Mappa I, Rizzo G, Dall'Asta A, Ghi T. The sonographic measurement of the ratio between the fetal head circumference and the obstetrical conjugate is accurate in predicting the risk of labor arrest: results from a multicenter prospective study. Am J Obstet Gynecol MFM 2022; 4:100710. [PMID: 35964934 DOI: 10.1016/j.ajogmf.2022.100710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/08/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Labor arrest is estimated to account for approximately one-third of all primary cesarean deliveries, and is associated with an increased risk of adverse maternal and perinatal outcomes. One of the main causes is the mismatch between the size of the birth canal and that of the fetus, a condition usually referred to as cephalopelvic disproportion. OBJECTIVE This study aimed to describe a new ultrasound predictor of labor arrest leading to cesarean delivery because of suspected cephalopelvic disproportion. STUDY DESIGN This was a multicenter prospective study conducted at 3 maternity units from January 2021 to January 2022. A nonconsecutive series of singleton pregnancies with cephalic-presenting fetuses, gestational age of 34 weeks+0 days or above, and no contraindication to vaginal delivery attending at the antenatal clinics of each institution were considered eligible. Between 34+0 and 38+0 weeks of gestation, all eligible patients were submitted to transabdominal 2D ultrasound measurement of the obstetrical conjugate. On admission to the labor ward, the fetal head circumference was measured on the standard transthalamic plane by transabdominal ultrasound. The primary outcome of the study was the accuracy of the ratio between the fetal head circumference and the obstetrical conjugate measurement (ie, head circumference/obstetrical conjugate ratio) in predicting the occurrence of cesarean delivery secondary to labor arrest. The secondary outcome was the relationship between the head circumference/obstetrical conjugate ratio and labor duration. RESULTS A total of 263 women were included. Cesarean delivery for labor arrest was performed in 7.6% (20/263) of the included cases and was associated with more frequent use of epidural analgesia (95.0% vs 45.7%; P<.001), longer second stage of labor (193 [120-240] vs 34.0 [13.8-66.5] minutes; P=.002), shorter obstetrical conjugate (111 [108-114] vs 121 [116-125] mm; P<.001), higher head circumference/obstetrical conjugate ratio (3.2 [3.2-3.35] vs 2.9 [2.8-3.0]; P<.001), and higher birthweight (3678 [3501-3916] vs 3352 [3095-3680] g; P=.003) compared with vaginal delivery. At logistic regression analysis, the head circumference/obstetrical conjugate ratio expressed as Z-score was the only parameter independently associated with risk of cesarean delivery for labor arrest (odds ratio, 8.8; 95% confidence interval, 3.6-21.7) and had higher accuracy in predicting cesarean delivery compared with the accuracy of fetal head circumference and obstetrical conjugate alone, with an area under the curve of 0.91 (95% confidence interval, 81.7-99.5; P<.001). A positive correlation between the head circumference/obstetrical conjugate ratio and length of the second stage of labor was found (Pearson coefficient, 0.16; P=.018). CONCLUSION Our study, conducted on an unselected low-risk population, demonstrated that the head circumference/obstetrical conjugate ratio is a reliable antenatal predictor of labor arrest leading to cesarean delivery.
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Affiliation(s)
- Elvira Di Pasquo
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy (Drs Di Pasquo, Morganelli, Volpe, Labadini, Ramirez Zegarra, Dall'Asta, and Ghi)
| | - Giovanni Morganelli
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy (Drs Di Pasquo, Morganelli, Volpe, Labadini, Ramirez Zegarra, Dall'Asta, and Ghi)
| | - Nicola Volpe
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy (Drs Di Pasquo, Morganelli, Volpe, Labadini, Ramirez Zegarra, Dall'Asta, and Ghi)
| | - Corinne Labadini
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy (Drs Di Pasquo, Morganelli, Volpe, Labadini, Ramirez Zegarra, Dall'Asta, and Ghi)
| | - Ruben Ramirez Zegarra
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy (Drs Di Pasquo, Morganelli, Volpe, Labadini, Ramirez Zegarra, Dall'Asta, and Ghi); Department of Obstetrics and Gynecology, St. Joseph Krankenhaus, Berlin, Germany (Drs Ramirez Zegarra and Abou-Dakn)
| | - Michael Abou-Dakn
- Department of Obstetrics and Gynecology, St. Joseph Krankenhaus, Berlin, Germany (Drs Ramirez Zegarra and Abou-Dakn)
| | - Ilenia Mappa
- Department of Obstetrics and Gynecology Medicine, Fondazione Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy (Drs Mappa and Rizzo)
| | - Giuseppe Rizzo
- Department of Obstetrics and Gynecology Medicine, Fondazione Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy (Drs Mappa and Rizzo)
| | - Andrea Dall'Asta
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy (Drs Di Pasquo, Morganelli, Volpe, Labadini, Ramirez Zegarra, Dall'Asta, and Ghi); Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy (Drs Dall'Asta and Ghi)
| | - Tullio Ghi
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy (Drs Di Pasquo, Morganelli, Volpe, Labadini, Ramirez Zegarra, Dall'Asta, and Ghi); Department of Medicine and Surgery, Obstetrics and Gynaecology Unit, University of Parma, Parma, Italy (Drs Dall'Asta and Ghi).
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Kamel R, Negm S, Badr I, Kahrs BH, Eggebø TM, Iversen JK. Fetal head descent assessed by transabdominal ultrasound: a prospective observational study. Am J Obstet Gynecol 2022; 226:112.e1-112.e10. [PMID: 34389293 DOI: 10.1016/j.ajog.2021.07.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/28/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Determining fetal head descent, expressed as fetal head station and engagement is an essential part of monitoring progression in labor. Assessing fetal head station is based on the distal part of the fetal skull, whereas assessing engagement is based on the proximal part. Prerequisites for assisted vaginal birth are that the fetal head should be engaged and its lowermost part at or below the level of the ischial spines. The part of the fetal head above the pelvic inlet reflects the true descent of the largest diameter of the skull. In molded (reshaped) fetal heads, the leading bony part of the skull may be below the ischial spines while the largest diameter of the fetal skull still remains above the pelvic inlet. An attempt at assisted vaginal birth in such a situation would be associated with risks. Therefore, the vaginal or transperineal assessments of station should be supplemented with a transabdominal examination. We suggest a method for the assessment of fetal head descent with transabdominal ultrasound. OBJECTIVE To investigate the correlation between transabdominal and transperineal assessment of fetal head descent, and to study fetal head shape at different labor stages and head positions. STUDY DESIGN Women with term singleton cephalic pregnancies admitted to the labor ward for induction of labor or in spontaneous labor, at the Cairo University Hospital and Oslo University Hospital from December 2019 to December 2020 were included. Fetal head descent was assessed with transabdominal ultrasound as the suprapubic descent angle between a longitudinal line through the symphysis pubis and a line from the upper part of the symphysis pubis extending tangentially to the fetal skull. We compared measurements with transperineally assessed angle of progression and investigated interobserver agreement. We also measured the part of fetal head above and below the symphysis pubis at different labor stages. RESULTS The study population comprised 123 women, of whom 19 (15%) were examined before induction of labor, 8 (7%) in the latent phase, 52 (42%) in the active first stage and 44 (36%) in the second stage. The suprapubic descent angle and the angle of progression could be measured in all cases. The correlation between the transabdominal and transperineal measurements was -0.90 (95% confidence interval, -0.86 to -0.93). Interobserver agreement was examined in 30 women and the intraclass correlation coefficient was 0.98 (95% confidence interval, 0.95-0.99). The limits of agreement were from -9.5 to 7.8 degrees. The fetal head was more elongated in occiput posterior position than in non-occiput posterior positions in the second stage of labor. CONCLUSION We present a novel method of examining fetal head descent by assessing the proximal part of the fetal skull with transabdominal ultrasound. The correlation with transperineal ultrasound measurements was strong, especially early in labor. The fetal head was elongated in the occiput posterior position during the second stage of labor.
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Correlation of mode of delivery with ultrasonic measurement of obstetric conjugate. JOURNAL OF RESEARCH IN APPLIED AND BASIC MEDICAL SCIENCES 2021. [DOI: 10.52547/rabms.7.2.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Di Pasquo E, Volpe N, Labadini C, Morganelli G, Di Tonto A, Schera GBL, Rizzo G, Frusca T, Ghi T. Antepartum evaluation of the obstetric conjugate at transabdominal 2D ultrasound: A feasibility study. Acta Obstet Gynecol Scand 2021; 100:1917-1923. [PMID: 34240404 DOI: 10.1111/aogs.14226] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The obstetric conjugate represents the shortest anteroposterior diameter of the birth canal and it reflects the capacity of the pelvic inlet to allow the passage and the engagement of the fetal head. The antepartum evaluation of this parameter may be attempted at digital examination to predict the risk of cephalopelvic disproportion, but the accuracy of clinical pelvimetry is notoriously poor. The aim of our study was to describe the sonographic measurement of the obstetric conjugate at transabdominal 2D-ultrasound and to assess its reproducibility. MATERIAL AND METHODS This is a prospective cohort study conducted at a tertiary University hospital. A non-consecutive series of pregnant women with uncomplicated singleton pregnancies attending the antenatal clinic for routine booking from 34 weeks of gestation onward were included. The ultrasound probe was longitudinally placed above the level of the symphysis and the interpubic fibrocartilaginous disk was visualized. Then the promontory was identified as the most prominent segment of the sacral vertebral column. The obstetric conjugate was measured as the distance between the inner edge of the interpubic disk and the promontory. The inter- and intraobserver repeatability of this measurement was calculated using the intraclass correlation coefficient (ICC) and the Bland-Altman method. RESULTS In all, 119 women were considered eligible for the study; of these, 111/119 (93.3%) women were included in the analysis with a median gestational age of 36.0 (35.0-37.0) weeks. The mean obstetric conjugate measurement was 11.4 ± 0.93 mm for the first operator and 11.4 ± 0.91 mm for the second operator. The overall interobserver ICC was 0.95 (95% [confidence interval] CI 0.92-0.96) and the overall intraobserver ICC was 0.97 (95% CI 0.96-0.98). Limits of agreement ranged from -0.84 to 0.80 for interobserver measures and from -0.64 to 0.62 for intraobserver measures. The degree of reliability was also analyzed for women with a body mass index ≥30 and for women with a gestational age ≥37 weeks. The inter- and intraobserver ICCs were respectively 0.97 (95% CI 0.90-0.98) and 0.98 (0.95-0.99) in the former group and 0.96 (95% CI 0.93-0.98) and 0.97 (95% CI 0.95-0.98) in the latter group. CONCLUSIONS Our study demonstrated that among pregnant women at term gestation, sonographic measurement of the obstetric conjugate is feasible and reproducible.
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Affiliation(s)
- Elvira Di Pasquo
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy
| | - Nicola Volpe
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy
| | - Corinne Labadini
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, Unit of Surgical Sciences, University of Parma, Parma, Italy
| | - Giovanni Morganelli
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, Unit of Surgical Sciences, University of Parma, Parma, Italy
| | - Andrea Di Tonto
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, Unit of Surgical Sciences, University of Parma, Parma, Italy
| | - Giovanni B L Schera
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, Unit of Surgical Sciences, University of Parma, Parma, Italy
| | - Giuseppe Rizzo
- Department of Maternal and Fetal Medicine, "Cristo Re" Hospital, University of Rome Tor Vergata, Rome, Italy
| | - Tiziana Frusca
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, Unit of Surgical Sciences, University of Parma, Parma, Italy
| | - Tullio Ghi
- Department of Obstetrics and Gynecology, University Hospital of Parma, Parma, Italy
- Department of Medicine and Surgery, Unit of Surgical Sciences, University of Parma, Parma, Italy
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Antepartum evaluation of the obstetric conjugate at transabdominal 2D ultrasound: A feasibility study. Acta Obstet Gynecol Scand 2021. [DOI: org/10.1111/aogs.14226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Yang Z, Xia Z, Li B, Yao X, Jin X, Wang X. Investigation of correlation between bony pelvis dimensions and pelvic organ prolapse in different compartments. Eur J Obstet Gynecol Reprod Biol 2020; 252:213-217. [PMID: 32622105 DOI: 10.1016/j.ejogrb.2020.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the association between bony pelvis dimensions and anterior, apical, and posterior compartment pelvic organ prolapse (POP) and explore the mechanism of different types of POP from an anatomical point of view. STUDY DESIGN A total of 253 patients with POP were selected as the experimental group (138 patients with anterior compartment defect, 86 with apical compartment defect, and 29 with posterior compartment defect); 253 patients with uterine myoma constituted the control group. Their demographics were recorded, and anteroposterior diameters of the pelvic inlet, intertuberous diameter, and interspinous diameter were measured. One-way analysis of variance, least significant difference t-test, and Student's t-test were used to evaluate the pelvic measurements among the four groups. RESULTS The anteroposterior diameter of the pelvic inlet in the apical compartment POP group was smaller than that in the other groups (P < 0.05). Interspinous diameters in the anterior and apical groups were larger than those in the posterior POP and control groups (P < 0.05). Intertuberous diameter in the control group was smaller than that in the anterior and apical POP groups and larger than that in the posterior POP group (P < 0.05). CONCLUSION Women with apical compartment POP are more likely to have a smaller anteroposterior diameter. Larger interspinous and intertuberous diameters were associated with anterior and apical POP, and smaller intertuberous diameter was associated with posterior POP.
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Affiliation(s)
- Zhiqi Yang
- Department of Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhijun Xia
- Department of Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
| | - Baoxiang Li
- Department of Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao Yao
- Department of Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin Jin
- Department of Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaoming Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, China
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Daghighi MH, Poureisa M, Ranjkesh M. Association between obstetric conjugate diameter measured by transabdominal ultrasonography during pregnancy and the type of delivery. IRANIAN JOURNAL OF RADIOLOGY 2013; 10:185-7. [PMID: 24348610 PMCID: PMC3857987 DOI: 10.5812/iranjradiol.13191] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 03/17/2013] [Accepted: 04/07/2013] [Indexed: 11/21/2022]
Abstract
Background Normal morphological features of the maternal pelvis are an important prerequisite to vaginal delivery. Objectives We aimed to evaluate the association between obstetric conjugate diameter (OCD) measured by ultrasonography and the type of delivery, vaginally (V) or by cesarean (C) section. Patients and Methods Pelvimetry was performed in 200 primigravid women for fetal cephalic presentation. The OCD was measured twice by transabdominal ultrasonography during 25-30 weeks and 30-35 weeks of pregnancy. Results The mean OCD of both sonographies in groups V and C was 125.51± 8.35 mm (105-144.5) and 112.99 ± 8.53 mm (96-134.5), respectively, which was significantly lower in group C (P<0.001). The values of OCD between the first and second measurements were not different significantly (P=0.065). C-section was indicated in 65 (32.5%) mothers. The optimal cut-off point for the OCD in the prediction of vaginal delivery was ≥ 119.75 mm, with a sensitivity and specificity of 80% and 78.5%, respectively. Conclusion The US measurement of OCD might be an accurate method that almost always remains constant during late pregnancy; it is easy to measure and might be confidentially employed for predicting C-section, but needs more precise studies to be used widely.
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Affiliation(s)
- Mohammad Hossein Daghighi
- Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Corresponding author: Mohammad Hossein Daghighi, Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Tel: +98-4113346911 Fax: +984113346911, E-mail:
| | - Masoud Poureisa
- Neurosciences Research Center (NSRC), Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahnaz Ranjkesh
- Department of Radiology, Radiotherapy and Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Kitajima M, Mawatari M, Aita K, Shigematsu M, Ogawa K, Hotokebuchi T. A simple method to determine the pelvic inclination angle based on anteroposterior radiographs. J Orthop Sci 2006; 11:342-6. [PMID: 16897196 DOI: 10.1007/s00776-006-1020-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2005] [Accepted: 03/07/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND The aim of this study was to propose a simple method to determine the pelvic inclination angle using anteroposterior radiographs of the hip. METHODS The 283 subjects were randomly selected from patients who had undergone hip surgery at our institution from July 2002 to June 2004. Anteroposterior (AP) and lateral radiographs of the pelvis were obtained in the standing position. To assess the pelvic inclination angle from AP radiographs, a formula was determined by a trigonometric function. A significant correlation between the angle calculated by the formula and the measured angle (theta(0)) on lateral radiographs was confirmed. The calculated angle (theta(1)) was obtained from two measured values: the pelvic foramen height (H) on AP radiographs and the pelvic foramen distance (D) on lateral radiographs. The formula used was as follows: sin theta = H/D. The calculated angle (theta(2)) was obtained from one measured value--the pelvic foramen height on AP radiographs--because the pelvic foramen distance on lateral radiographs substituted for the average of the pelvic foramen distance investigated in 236 patients. The formula was sin theta = H/average. RESULTS The correlation between the calculated angle (theta(1)) and the measured angle (theta(0)) was significant, and the correlation between calculated angle theta(1) and calculated angle theta(2) was also significant. CONCLUSIONS The pelvic inclination angle can be estimated by measuring the height of the pelvic foramen according to our formula. Our formula was shown to have adequate reliability and reproducibility.
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Affiliation(s)
- Masaru Kitajima
- Faculty of Medicine, Saga University, 1-1 Nabeshima 5-chome, Saga 849-0937, Japan
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Affiliation(s)
- J E Ferguson
- Department of Obstetrics and Gynecology, University of Virginia Health Systems, Charlottesville 22906, USA
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