MR Pelvimetry

  • Leonhard Schäffer
  • Ernst Beinder
  • Rahel A. Kubik-HuchEmail author
Part of the Medical Radiology book series (MEDRAD)


Arrest of labor with the necessity of performing secondary cesarean section is a major cause of maternal morbidity and mortality. The fetus is likewise affected by prolonged labor. Pelvimetry is performed to identify those women in whom an attempt at vaginal delivery is likely to fail due to a narrow pelvis or pelvic anomaly. Hence, the clinical significance of pelvimetry depends on how the following questions are answered:
  • Is primary cesarean section associated with a lower morbidity and mortality of mother and child than secondary cesarean section after arrested labor has been diagnosed?

  • Can arrested labor be treated effectively?

  • Is there a reproducible method of pelvimetry with few side effects?

  • Is there evidence from randomized and controlled studies that pelvimetry improves maternal and/or fetal outcome?


  1. Abilgaard H et al (2013) Cervical dilation at the time of cesarean section for dystocia – effect on subsequent trial of labor. Acta Obstet Gynecol Scand 92:193–197CrossRefGoogle Scholar
  2. Angioli R, Gomez-Marin O, Cantuaria G, O’Sullivan JM (2000) Severe perineal lacerations during vaginal delivery: the University of Miami experience. Am J Obstet Gynecol 182:1083–1085CrossRefGoogle Scholar
  3. Baker PN, Johnson IR, Harvey PR, Gowland PA, Mansfield P (1994) A three-year follow-up of children imaged in utero with echo-planar magnetic resonance. Am J Obstet Gynecol 170:32–33CrossRefGoogle Scholar
  4. Cardozo LD, Gibb DM, Studd JW et al (1982) Predictive value of cervimetric labour patterns in primigravidae. Br J Obstet Gynaecol 82:33–38CrossRefGoogle Scholar
  5. D’Souza R et al (2013) Cesarean section on maternal request for non-medical reasons. Best Practice Res Clini Obstetrics Gynaeco 27(2):165–177CrossRefGoogle Scholar
  6. DeWilde JP, Rivers AW, Price DL (2005) A review of the current use of magnetic resonance imaging in pregnancy and safety implications for the fetus. Prog Biophys Mol Biol 87:335–353CrossRefGoogle Scholar
  7. Doll R, Wakeford R (1997) Risk of childhood cancer from fetal irradiation. Br J Radiol 70:130–139CrossRefGoogle Scholar
  8. Fox LK, Huerta-Enochian GS, Hamlin JA, Katz VL (2004) The magnetic resonance imaging-based fetal-pelvic index: a pilot study in the community hospital. Am J Obstet Gynecol 190:1679–1688CrossRefGoogle Scholar
  9. Friedman EA (1955) Primigravid labor. Obstet Gynecol 6:567–589CrossRefGoogle Scholar
  10. Friedman EA (1956) Labor in multiparae. Obstet Gynecol 8:691–703PubMedGoogle Scholar
  11. Hannah ME, Hannah WJ, Hewson SA et al (2000) Planned caesarean section versus planned vaginal birth for breech presentation at term: a randomised multicentre trial. Term Breech Trial Collaborative Group. Lancet 356:1375–1483CrossRefGoogle Scholar
  12. Kanal E, Gillen J, Evans JA, Savitz DA, Shellock FG (1993) Survey of reproductive health among female MR workers. Radiology 187:395–399CrossRefGoogle Scholar
  13. Keller TM, Rake A, Michel SCA, Seifert B, Efe G, Treiber K, Huch R, Marincek B, Kubik-Huch R (2003) Obstetric MR pelvimetry: reference values and evaluation of inter- and intraobserver error and intraindividual variability. Radiology 227:37–43CrossRefGoogle Scholar
  14. Liselele HB, Boulvain M, Tshibangu KC, Meuris S (2000) Maternal height and external pelvimetry to predict cephalopelvic disproportion in nulliparous African women: a cohort study. Br J Obstet Gynaecol 107:947–952CrossRefGoogle Scholar
  15. Masselli G, Derchi L, McHugo J et al (2013) Acute abdominal and pelvic pain in pregnancy: ESUR recommendations. Eur Radiol 23:3485–3500CrossRefGoogle Scholar
  16. Michel SC, Rake A, Treiber K, Seifert B, Chaoui R, Huch R, Marincek M, Kubik-Huch RA (2002) MR obstetric pelvimetry: effect of birthing position on pelvic bony dimensions. AJR Am J Roentgenol 179:1063–1067CrossRefGoogle Scholar
  17. Müttersterblichkeit WH (2004) In: Schneider H, Husslein P, Schneider KTM (eds) Die Geburtshilfe, 2nd edn. Berlin/Heidelberg/New York, VerlagGoogle Scholar
  18. O’Brien K, Rode M, Macones G (2002) Postpartum X-ray pelvimetry. Its use in calculating the fetal-pelvic index and predicting fetal-pelvic disproportion. J Reprod Med 47:845–848PubMedGoogle Scholar
  19. Pattinson RC, Farrell E (1997) Pelvimetry for fetal cephalic presentations at or near term. Cochrane Database Sys Rev (2):CD000161. doi:10.1002/14651858CD00161Google Scholar
  20. Pfammatter T, Marincek B, von Schulthess GK, Dudenhausen JW (1990) MR pelvimetric reference values. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 153:706–710CrossRefGoogle Scholar
  21. Ray Joel G, Vermeulen Marian J et al (2016) Association between MRI exposure during pregnancy and fetal and childhood outcomes. JAMA 316:952–961CrossRefGoogle Scholar
  22. Shellock Frank G, Crues John V (2003) MR procedures: biologic effects, safety, and patient care. Radiology 232:635–652CrossRefGoogle Scholar
  23. Spong CY et al (2012) Preventing the first cesarean delivery: summary of a joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and American College of Obstetricians and Gynecologists Workshop. Obstet Gynecol 120:1181PubMedPubMedCentralGoogle Scholar
  24. Spörri S, Thoeny HC, Raio L, Lachat R, Vock P, Schneider H (2002) MR imaging pelvimetry: a useful adjunct in the treatment of women at risk for dystocia. AJR Am J Roentgenol 179:137–144CrossRefGoogle Scholar
  25. Stark DD, McCarthy SM, Filly RA, Parer JT, Hricak H, Callen PW (1985) Pelvimetry by magnetic resonance imaging. AJR Am J Roentgenol 144:947–950CrossRefGoogle Scholar
  26. Stewart A, Kneale GW (1968) Changes in the cancer risk associated with obstetric radiography. Lancet 1:104–107CrossRefGoogle Scholar
  27. Urhahn R, Lehnen H, Drobnitzky M, Klose KC, Gunther RW (1991) Ultrafast pelvimetry using Snapshot-FLASH-MRT – a comparison with the Spinecho and FLASH techniques. Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr 155:432–435CrossRefGoogle Scholar
  28. van Loon AJ, Mantingh A, Thijn CJ, Mooyaart EL (1990) Pelvimetry by magnetic resonance imaging in breech presentation. Am J Obstet Gynecol 163:1256–1260CrossRefGoogle Scholar
  29. Van Loon AJ, Mantingh A, Serlier EK, Kroon G, Mooyaart EL, Huisjes HJ (1997) Randomised controlled trial of magnetic-resonance pelvimetry in breech presentation at term. Lancet 350:1799–1804CrossRefGoogle Scholar
  30. Wentz KU, Lehmann KJ, Wischnik A et al (1994) Pelvimetry using various magnetic resonance tomography techniques vs. digital image enhancement radiography: accuracy, time requirement and energy exposure. Geburtshilfe Frauenheilkd 54:204–212CrossRefGoogle Scholar
  31. Wright AR, English PT, Cameron HM, Wilsdon JB (1992) MR pelvimetry – a practical alternative. Acta Radiol 33:582–587PubMedGoogle Scholar
  32. Zhang J et al (2010) The natural history of the normal stage of labor. Obstet Gynecol 115:705CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Leonhard Schäffer
    • 1
  • Ernst Beinder
    • 1
  • Rahel A. Kubik-Huch
    • 1
    Email author
  1. 1.Departments of Obstetrics and RadiologyKantonsspital Baden AGBadenSwitzerland

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