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MR pelvimetry: prognosis for successful vaginal delivery in patients with suspected fetopelvic disproportion or breech presentation at term

  • Maternal-Fetal Medicine
  • Published:
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Abstract

Purpose

The purpose of this study was to correlate MR pelvimetric pelvic inlet measurements with mode of delivery and neonatal outcome in patients with suspected fetopelvic disproportion or breech presentation.

Methods

For this retrospective monocentric study, 237 consecutive MR pelvimetry reports (1999–2016) of pregnant women due to either suspected fetopelvic disproportion, pelvic deformation after trauma, or persistent breech presentation were retrieved from the radiologic database and matched with corresponding information from the obstetric database.

Results

Of 223 included women, 95 (42.6%) underwent planned cesarean section (pCS) and 128 (57.4%) underwent a trial of vaginal labour (TOL), of whom 93 (72.7%) delivered vaginally. Vaginal delivery was successful in 45 out of 64 (70.3%) cephalic cases and in 48 out of 64 (75.0%) breech cases. We found statistically significant differences in conjugata vera obstetrica (CV) and diameter transversalis (DT) between the groups TOL and pCS (CV: 12.5 ± 1.0 vs 12.1 ± 1.2 cm, p value 0.001; DT: 13.3 ± 0.9 vs 12.7 ± 0.9 cm, p value <0.001, respectively). However, there was no significant difference between successful VD and cesarean section after TOL (CV: 12.5 ± 0.9 vs 12.3 ± 1.1 cm, p value 0.194; DT: 13.4 ± 0.9 vs 13.2 ± 0.9 cm, p value 0.358, respectively).

Conclusions

In our cohort, MR pelvimetry was a useful tool for prepartal assessment of the female pelvis in the selection of TOL candidates. Yet, it does not seem to yield additional predictive value for women with a previous vaginal delivery.

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Acknowledgements

The authors thank Regina Schinner for her statistical assistance.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany

    Marie Franz, Amanda von Bismarck, Maria Delius, Charlotte Deppe, Sven Mahner, Uwe Hasbargen & Christoph Hübener

  2. Institute for Clinical Radiology, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany

    Birgit Ertl-Wagner

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  1. Marie Franz
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Correspondence to Christoph Hübener.

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Franz, M., von Bismarck, A., Delius, M. et al. MR pelvimetry: prognosis for successful vaginal delivery in patients with suspected fetopelvic disproportion or breech presentation at term. Arch Gynecol Obstet 295, 351–359 (2017). https://doi.org/10.1007/s00404-016-4276-6

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