Pelvic capacity in pregnant women, identified using magnetic resonance imaging

TY - JOUR

T1 - Pelvic capacity in pregnant women, identified using magnetic resonance imaging

AU - Kjeldsen, Louise Lilleøre

AU - Blankholm, Anne Dorte

AU - Jurik, Anne Grethe

AU - Salvig, Jannie Dalby

AU - Maimburg, Rikke Damkjær

PY - 2021/8

Y1 - 2021/8

N2 - Introduction: Maternal pelvic capacity plays a major role during childbirth because the passage of the fetus through the bony birth canal enables vaginal birth. Maternal birthing position may influence pelvic capacity because upright positions optimize capacity, possibly due to free movement of the pelvic joints. Herein, pelvic capacity was assessed by comparing changes in pelvic dimensions across pregnancy and in three birthing positions. Material and methods: This diagnostic imaging study of 50 pregnant women was conducted at Aarhus University Hospital, Denmark. Pelvic measurements were obtained with 1.5 T magnetic resonance pelvimetry during gestational weeks 20 and 32, in three birthing positions: kneeling squat, semi-lithotomy and supine. Pelvic capacity was compared between gestational weeks and positions. Results: In all three positions there is an overall increase in pelvic capacity from gestational week 20–32 at both the pelvic inlet and outlet. Comparing pelvic capacity at gestational week 32 between the semi-lithotomy and supine positions revealed that the pelvic inlet was larger in the supine position, whereas the mean pelvic outlet was 0.2 cm (p < 0.001) larger in the semi-lithotomy position. Likewise, the pelvic inlet was larger in the supine than in the kneeling squat position. Shifting from supine to kneeling squat position increased the midplane and pelvic outlet dimensions by up to 1 cm (p < 0.001). Conclusions: The finding herein of an increased pelvic capacity as the pregnancy progresses is novel. Further, the results indicate that the supine position is optimal for increasing pelvic inlet size, whereas the semi-lithotomy and kneeling squat positions are optimal for increasing mid- and outlet-pelvic capacities.

AB - Introduction: Maternal pelvic capacity plays a major role during childbirth because the passage of the fetus through the bony birth canal enables vaginal birth. Maternal birthing position may influence pelvic capacity because upright positions optimize capacity, possibly due to free movement of the pelvic joints. Herein, pelvic capacity was assessed by comparing changes in pelvic dimensions across pregnancy and in three birthing positions. Material and methods: This diagnostic imaging study of 50 pregnant women was conducted at Aarhus University Hospital, Denmark. Pelvic measurements were obtained with 1.5 T magnetic resonance pelvimetry during gestational weeks 20 and 32, in three birthing positions: kneeling squat, semi-lithotomy and supine. Pelvic capacity was compared between gestational weeks and positions. Results: In all three positions there is an overall increase in pelvic capacity from gestational week 20–32 at both the pelvic inlet and outlet. Comparing pelvic capacity at gestational week 32 between the semi-lithotomy and supine positions revealed that the pelvic inlet was larger in the supine position, whereas the mean pelvic outlet was 0.2 cm (p < 0.001) larger in the semi-lithotomy position. Likewise, the pelvic inlet was larger in the supine than in the kneeling squat position. Shifting from supine to kneeling squat position increased the midplane and pelvic outlet dimensions by up to 1 cm (p < 0.001). Conclusions: The finding herein of an increased pelvic capacity as the pregnancy progresses is novel. Further, the results indicate that the supine position is optimal for increasing pelvic inlet size, whereas the semi-lithotomy and kneeling squat positions are optimal for increasing mid- and outlet-pelvic capacities.

KW - birthing positions

KW - magnetic resonance imaging

KW - pelvic capacity

KW - pelvimetry

KW - physiological childbirth

KW - pregnancy

KW - PELVIMETRY

KW - RELAXIN

U2 - 10.1111/aogs.14168

DO - 10.1111/aogs.14168

M3 - Journal article

C2 - 33991336

SN - 0001-6349

VL - 100

SP - 1454

EP - 1462

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

IS - 8

ER -