Diagnostic Value of Clinical Pelvimetry and Sonopelvimetry in Determining Mode of Delivery in Nulliparous Women

Abstract

Background:Normal morphological features of the maternal pelvis are important prerequisites for vaginal delivery. Clinical pelvimetry and sonopelvimetry are inexpensive methods of assessing pelvic capacity. This study aims to determine the diagnostic accuracy of clinical pelvimetry and sonopelvimetry in predicting the mode of delivery in nulliparous women.Materials and Methods:In this cross-sectional study, 210 nulliparous women who came for delivery were assessed regarding their clinical and trans-abdominal ultrasonographic pelvimetry characteristics. Parameters including sacral promontory, diagonal conjugate diameter, curvature of the sacrum, interspinous diameter, side walls, sacrosciatic notch, and sub-pubic arch, prominence of coccyx, and intertubberous diameter were evaluated through clinical pelvimetry. Sonopelvimetry was performed to determine diagonal conjugate diameter. The measurements were compared between those who delivered through the vaginal route versus cesarean section (C/S). The receiver operating curve was depicted to determine the value of pelvimetry to prognosticate delivery mode.Results:Sacral promontory, diagonal conjugate diameter, curvature of the sacrum, interspinous diameter, side walls, sacrosciatic notch, sub-pubic arch, prominence of coccyx, and inter tuberous diameter were insignificantly different between those who delivered through the vaginal route versus C/S (P > 0.05). The mean diagonal conjugate diameter in ultrasonography assessments was 119.29 +/- 7.80 mm in those undergoing C/S versus 120.12 +/- 8.72 mm for NVD ones (P value = 0.659). None of the pelvic inlet, mid-pelvic, and outlet parameters could statistically predict the probability of CPD (P value > 0.05).Conclusion:Based on the findings of this study, neither clinical pelvimetric parameters nor trans-abdominal ultrasonography could appropriately prognosticate delivery appropriateness through the vaginal route.