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MR Imaging Pelvimetry: A Useful Adjunct in the Treatment of Women at Risk for Dystocia?

Stefan Spörri1,2, Harriet C. Thoeny3, Luigi Raio1, Remo Lachat2, Peter Vock3 and Henning Schneider1

1 Department of Obstetrics and Gynecology, University of Bern, Inselspital, Effingerstr. 3010 Bern, Switzerland.
2 Department of Obstetrics and Gynecology, Kantonsspital, 1708 Freiburg, Switzerland.
3 Institute of Diagnostic Radiology, University of Bern, Inselspital, 3010 Bern, Switzerland.



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  		Fig. 1. —35-year-old multipara with singleton pregnancy and vertex presentation at term. Sagittal midline T1-weighted fast spin-echo MR image shows normal pelvic configuration with even curve of sacrum and measurement of obstetric conjugate (1), mid pelvis sagittal diameter (2), and outlet sagittal diameter (3). Mid pelvis sagittal diameter is measured according to radiographic technique [11, 19] from lower point of symphysis along line to sacrum through interspinal diameter (+) that is easily projected from axial section into mid sagittal section by MR imaging program.

 


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  		Fig. 2. —26-year-old primipara at term. Axial T1-weighted fast spin-echo MR image shows measurement of interspinal diameter (1).

 


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  		Fig. 3. —35-year-old multipara with singleton pregnancy and vertex presentation at term. Axial T1-weighted fast spin-echo MR image shows measurement of intertuberous diameter (1).

 


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  		Fig. 4. —26-year-old primipara with singleton pregnancy and vertex presentation at term. Oblique coronal T1-weighted fast spin-echo MR image shows measurement of transverse diameter of pelvic inlet (1) and its normal gynecoid shape.

 


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  		Fig. 5. —36-year-old primipara with singleton pregnancy and vertex presentation at term. Sagittal T1-weighted fast spin-echo MR image shows abnormal pelvic configuration with extremely deep sacral curve. 1 = obstetric conjugate, 2 = mid pelvis sagittal diameter, 3 = outlet sagittal diameter.

 


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  		Fig. 6. —28-year-old primipara with singleton pregnancy and vertex presentation at term. Sagittal T1-weighted fast spin-echo MR image shows os coccyx forming angle of almost 90° with flat sacrum. 1 = pelvic inlet angle, 2 = pelvic aperture angle.

 


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  		Fig. 7. —27-year-old multipara at term. Oblique coronal T1-weighted fast spin-echo MR image shows abnormal android shape of pelvic inlet. 1 = transverse diameter of pelvic inlet.

 

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