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Predictive Value of MRI Pelvimetry in Vaginal Delivery and Its Practicability in Prolonged Labour—A Prospective Cohort Study

Background: Pelvic dimensions are crucial variables in the labour process. We used magnetic resonance imaging (MRI) pelvimetry to predict the probability of vaginal delivery and distinguish the cephalopelvic disproportion risk in women with prolonged active labour. Methods: This prospective cohort s...

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Autores principales: Li, Juan, Lou, Ying, Chen, Cheng, Zheng, Weizeng, Chen, Yuan, Dong, Tian, Yang, Mengmeng, Zhao, Baihui, Luo, Qiong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862888/
https://www.ncbi.nlm.nih.gov/pubmed/36675370
http://dx.doi.org/10.3390/jcm12020442
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author Li, Juan
Lou, Ying
Chen, Cheng
Zheng, Weizeng
Chen, Yuan
Dong, Tian
Yang, Mengmeng
Zhao, Baihui
Luo, Qiong
author_facet Li, Juan
Lou, Ying
Chen, Cheng
Zheng, Weizeng
Chen, Yuan
Dong, Tian
Yang, Mengmeng
Zhao, Baihui
Luo, Qiong
author_sort Li, Juan
collection PubMed
description Background: Pelvic dimensions are crucial variables in the labour process. We used magnetic resonance imaging (MRI) pelvimetry to predict the probability of vaginal delivery and distinguish the cephalopelvic disproportion risk in women with prolonged active labour. Methods: This prospective cohort study enrolled term nulliparous women willing to undergo MRI pelvimetry and a trial of labour. A nomogram, with vaginal birth as the outcome, was developed and evaluated by calibration curve and decision curve analyses. The pairwise association between maternal and fetal parameters and a prolonged first stage of labour was quantified. Results: Head circumference (HC), abdominal circumference (AC), intertuberous distance (ITD), interspinous diameter (ISD), and body mass index (BMI) were introduced to develop a nomogram with good diagnostic performance (area under the curve = 0.799, sensitivity = 83%, and specificity = 73%). The cephalopelvic index of diameter (CID) in 54 women with a prolonged first stage of labour was much smaller in those who delivered via cesarean section compared with those who delivered vaginally (18.09 ± 1.14 vs. 21.29 ± 1.06; p = 0.046). Conclusions: An MRI pelvimetry-based nomogram may predict the probability of vaginal delivery. Practitioners should reassess the pelvimetry parameters to decide whether the trial of labour should be continued if it is prolonged.
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spelling pubmed-98628882023-01-22 Predictive Value of MRI Pelvimetry in Vaginal Delivery and Its Practicability in Prolonged Labour—A Prospective Cohort Study Li, Juan Lou, Ying Chen, Cheng Zheng, Weizeng Chen, Yuan Dong, Tian Yang, Mengmeng Zhao, Baihui Luo, Qiong J Clin Med Article Background: Pelvic dimensions are crucial variables in the labour process. We used magnetic resonance imaging (MRI) pelvimetry to predict the probability of vaginal delivery and distinguish the cephalopelvic disproportion risk in women with prolonged active labour. Methods: This prospective cohort study enrolled term nulliparous women willing to undergo MRI pelvimetry and a trial of labour. A nomogram, with vaginal birth as the outcome, was developed and evaluated by calibration curve and decision curve analyses. The pairwise association between maternal and fetal parameters and a prolonged first stage of labour was quantified. Results: Head circumference (HC), abdominal circumference (AC), intertuberous distance (ITD), interspinous diameter (ISD), and body mass index (BMI) were introduced to develop a nomogram with good diagnostic performance (area under the curve = 0.799, sensitivity = 83%, and specificity = 73%). The cephalopelvic index of diameter (CID) in 54 women with a prolonged first stage of labour was much smaller in those who delivered via cesarean section compared with those who delivered vaginally (18.09 ± 1.14 vs. 21.29 ± 1.06; p = 0.046). Conclusions: An MRI pelvimetry-based nomogram may predict the probability of vaginal delivery. Practitioners should reassess the pelvimetry parameters to decide whether the trial of labour should be continued if it is prolonged. MDPI 2023-01-05 /pmc/articles/PMC9862888/ /pubmed/36675370 http://dx.doi.org/10.3390/jcm12020442 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Li, Juan
Lou, Ying
Chen, Cheng
Zheng, Weizeng
Chen, Yuan
Dong, Tian
Yang, Mengmeng
Zhao, Baihui
Luo, Qiong
Predictive Value of MRI Pelvimetry in Vaginal Delivery and Its Practicability in Prolonged Labour—A Prospective Cohort Study
title Predictive Value of MRI Pelvimetry in Vaginal Delivery and Its Practicability in Prolonged Labour—A Prospective Cohort Study
title_full Predictive Value of MRI Pelvimetry in Vaginal Delivery and Its Practicability in Prolonged Labour—A Prospective Cohort Study
title_fullStr Predictive Value of MRI Pelvimetry in Vaginal Delivery and Its Practicability in Prolonged Labour—A Prospective Cohort Study
title_full_unstemmed Predictive Value of MRI Pelvimetry in Vaginal Delivery and Its Practicability in Prolonged Labour—A Prospective Cohort Study
title_short Predictive Value of MRI Pelvimetry in Vaginal Delivery and Its Practicability in Prolonged Labour—A Prospective Cohort Study
title_sort predictive value of mri pelvimetry in vaginal delivery and its practicability in prolonged labour—a prospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9862888/
https://www.ncbi.nlm.nih.gov/pubmed/36675370
http://dx.doi.org/10.3390/jcm12020442
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