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The fetal-pelvic index as an indicator of fetal-pelvic disproportion: A preliminary report

  • Mark A. Morgan
    Correspondence
    Reprint requests: Mark A. Morgan, M.D., Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, P. O. Box 26901, Oklahoma City, OK 73190.
    Affiliations
    Division of Maternal/Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine Oklahoma City, Oklahoma USA.
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  • Gary R. Thurnau
    Affiliations
    Division of Maternal/Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine Oklahoma City, Oklahoma USA.
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  • John I. Fishburne Jr.
    Affiliations
    Division of Maternal/Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine Oklahoma City, Oklahoma USA.
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      Abstract

      The objective of this study was to develop a standardized method of identifying fetal-pelvic disproportion by comparing fetal head and abdomen circumferences with the respective maternal pelvic inlet and midpelvis circumferences. Fetal ultrasound and maternal x-ray pelvimetry measurements were performed on 75 term pregnant women with indications for a trial of labor. By means of individually measured fetal and matemal pelvic diameters, circumferences of the fetal head, fetal abdomen, maternal pelvic inlet, and maternal midpelvis were computed. Based on four circumference differences between the fetus and maternal pelvis (fetal head - maternal pelvic inlet, fetal head - maternal midpelvis, fetal abdomen - maternal pelvic inlet, and fetal abdomen - maternal midpelvis), a fetal pelvic index number was derived from the sum of the two most positive values. Of the 27 patients requiring cesarean sections for failure to progress in labor, all but four had positive fetal pelvic index values (sensitivity = 85%). Of the 48 patients who were delivered vaginally, all but four had negative fetal pelvic index values (specificity = 92%).

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      References

        • Jagani N
        • Schulman H
        • Chandra P
        • Gonzalez R
        • Fleischer A
        The predictability of labor outcome from a comparison of birth weight and x-ray pelvimetry.
        Am J Obstet Gynecol. 1981; 139: 507
      1. Pritchard JA MacDonald PC Dystocia caused by pelvic contraction. 17th ed. Williams obstetrics. Appleton-Century-Crofts, New York1984
        • Mengert WF
        Estimation of pelvic capacity.
        JAMA. 1948; 138: 159
        • Colcher AE
        • Sussman W
        A practical technique for roentgen pelvimetry with a new positioning.
        AJR. 1944; 51: 207
        • Kaltreider DF
        Criteria of inlet contraction: what is their value.
        Am J Obstet Gynecol. 1951; 62: 600
        • Shepard MJ
        • Richards VA
        • Berkowitz RL
        • Warsof SL
        • Hobbins JC
        An evaluation of two equations for predicting fetal weight by ultrasound.
        Am J Obstet Gynecol. 1982; 142: 47
        • Joyce DN
        • Giwa-Osagie F
        • Stevenson GW
        Role of pelvimetry in active management of labour.
        Br Med J. 1975; 4: 505
        • Klapholz H
        Evaluation of fetopelvic relationships.
        in: Cohen WR Friedman EA Management of labor. University Park Press, Baltimore1983
        • Friedman EA
        The therapeutic dilemma of arrested labor.
        Contemp Obstet Gynecol. 1978; 11: 34
        • Stewart KS
        • Philpott RH
        Fetal response to cephalopelvic disproportion.
        Br J Obstet Gynaecol. 1980; 87: 641
        • Fine EA
        • Bracken M
        • Berkowitz RL
        An evaluation of the usefulness of x-ray pelvimetry: comparison of the Thoms and modified Ball methods with manual pelvimetry.
        Am J Obstet Gynecol. 1980; 137: 15
        • Brent RL
        Irradiation in pregnancy.
        in: 3rd ed. Gynecology and obstetrics. vol 2. Harper & Row, Co, Philadelphia1979
        • Harvey EB
        • Boice JD
        • Honeyman M
        • Flannery JT
        Prenatal x-ray exposure and childhood cancer in twins.
        N Engl J Med. 1985; 312: 541
        • Jablon S
        • Kato H
        Childhood cancer in relation to prenatal exposure to atomic-bomb radiation.
        Lancet. 1970; 2: 1000
        • American Institute of Ultrasound in Medicine
        Bioeffects committee.
        J Ultrasound Med. 1983; 2: R14
        • Steer CM
        Moloy's evaluation of the pelvis in obstetrics.
        3rd ed. Plenum Press, New York1975