The Diagnostic Accuracy of Clinical Pelvimetry in Identifying Small Pelvis in Nulliparous Women

Document Type : Original Article


1 M.Sc. of midwifery, Health Center of Ardabil, Ardabil, Iran.

2 M.Sc. of midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Professor of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 M.Sc. of Vital Statistics, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Normal morphological features and size of the maternal pelvis are important prerequisitesto vaginal delivery. Advanced methods of pelvimetry are expensive and not widely available in developing countries. Clinical pelvimetry is an inexpensive method of assessing the pelvic capacity and is widely used. The objective of this study was to determine the diagnostic accuracy of clinical pelvimetry in identifying small pelvis in nulliparous women.
Methods: In this double blind prospective analytical study (December 2008 and June 2009) 527 nulliparous women who referred to the Ommolbanin hospital of Mashhad, entered the study. Clinical pelvimetry was performed at the admission and the capacity of pelvic inlet, mid-pelvis and pelvic outlets were determined. Data were analyzed by SPSS 11.5 software and fisher exact test and Chi- square test were use for comparison of pelvic capacity in the two groups.
Results: Flat sacrum (p=0/003), ischial spine distance less than 10cm (p=0/000), convergent pelvic wall (p=0/000), the pupic arc size less than 2 fingers (p=0/000) and the distance between the ischial tuberosities less than 9 cm (p=0/000) were observed more in the dystocia group. The combination of inlet measurements had the best sensitivity (33/3%). The combination of outlet and the combination of mid-pelvic measurements had the lowest sensitivity (4.6%).
Conclusion: Clinical pelvimetry is not an accurate method for indentifying small pelvis in nulliparous women and trial of labor should not be put aside on the base of clinical pelvimetry results.


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