Journal of obstetrics and women's diseasesJournal of obstetrics and women's diseases1684-04611683-9366Eco-Vector768110.17816/JOWD66620-29Research ArticleSignificance of ultrasound pelviometry in the diagnostics of anatomical and clinical narrow pelvisMudrovViktor A.<p>Assistant</p>mudrov_viktor@mail.ruChatskisElena M.<p>Head of Department</p>len130922@yandex.ruNizhegorodtsevaDaria A.<p>specialist in ultrasound diagnostics</p>stafffsss@mail.ruTttjanElena V.<p>specialist in ultrasound diagnostics</p>elena.tttyan@yandex.ruChita State Medical AcademyRoad Clinical Hospital at the station Chita-2 of the OJSC “Russian Railways”Regional Clinical HospitalCity Maternity Hospital15122017666202915122017Copyright © 2017, Mudrov V.A., Chatskis E.M., Nizhegorodtseva D.A., Tttjan E.V.2017<p>Rational management of labor with a narrow pelvis is one of the most difficult sections of practical obstetrics, because narrow pelvis is the main cause of birth trauma and childhood disability.</p>
<p>The aim of the study was to determine significance of ultrasound pelviometry in the diagnostics of anatomical and clinical narrow pelvis. On the basis of maternity hospitals of Trans-Baikal Region in the years 2013-2017 was held retrospective and prospective analysis of 150 labor histories, which were divided into 3 equal groups: group 1 pregnant women with normal sizes of the large pelvis, group 2 pregnant women with macrosomia, group 3 pregnant women with a reduced sizes of the large pelvis. Ultrasonic pelvimetry included measurement of direct and transverse sizes of the planes of the pelvic cavity and the angle of the pubic arc through the integrated use of abdominal, transvaginal and translabial sensors of ultrasound machine Toshiba Aplio 500. In the group of pregnant women with normal sizes of the large pelvis frequency of diagnosis of anatomical narrow pelvis used by ultrasound pelvimetry is 32%. In the group of pregnant women with macrosomia is dominated the normal size of the pelvic cavity (62%) and wide pelvis (18%). In 20 % of cases the diagnosis of anatomical narrow pelvis in group 3 was not confirmed by the data of ultrasonic pelvimetry. The most common forms of the narrow pelvis were the transversal pelvis (46%), the simple flat pelvis (14%), the uniformly narrow pelvis (10%). On the basis of mathematical modeling defined pattern, which is expressed by the formula:</p>
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<p>where AE angle extension of the head, PC angle of the pubic arc, TD1 transverse size of the plane of the entrance, TD2 transverse size of the plane of the output, FD1 direct size of the plane of the entrance, FD2 direct size of the narrowest part of the pelvic cavity, GA gestational age, BPD biparietal size, OFD fronto-occipital size of the fetuss head. When the value of the coefficient less than 1 is projected clinically narrow pelvis (r2 = 0,92). Thus, ultrasonic pelvimetry allows to determine not only the size of the pelvic cavity, but also to predict clinically narrow pelvis.</p>ultrasonic pelviometrypelviometrynarrow pelvismacrosomiafetal-pelvic disproportionультразвуковая пельвиометрияпельвиометрияузкий тазкрупный плодплодово-тазовая диспропорция[1. Клинические рекомендации (протокол лечения) Министерства здравоохранения Российской Федерации № 15-4/10/2-3402 от 23 мая 2017 г. «Оказание медицинской помощи при анатомически и клинически узком тазе». [Klinicheskie rekomendacii (protokol lechenija) Ministerstva zdravoohranenija Rossijskoj Federacii No 15-4/10/2-3402 of 23 May 2017. Okazanie medicinskoj pomoshhi pri anatomicheski i klinicheski uzkom taze. (In Russ.)]][2. Чернуха Е.А., Волобуев А.И., Пучко Т.К. Анатомически и клинически узкий таз. – М.: Триада-Х, 2005. [Chernukha EA, Volobuev AI, Puchko TK. Anatomicheski i klinicheski uzkii taz. Moscow: Triada-X; 2005. (In Russ.)]][3. Серов В.Н., Сухих Г.Т. Акушерство и гинекология: клинические рекомендации. – М.: ГЭОТАР-Медиа, 2014. [Serov VN, Sukhikh GT. Akusherstvo i ginekologiya: klinicheskie rekomendatsii. Moscow: GEOTAR-Media; 2014. (In Russ.)]][4. Казанцева Е.В., Мочалова М.Н., Ахметова Е.С., и др. Определение оптимального метода родоразрешения у беременных крупным плодом // Забайкальский медицинский вестник. – 2012. – № 1. – С. 9–11. [Kazantseva EV, Mochalova MN, Akhmetova ES, et al. Opredelenie optimal’nogo metoda rodorazresheniya u beremennykh krupnym plodom. Zabaikal’skii medi tsinskii vestnik. 2012;1:9-11. (In Russ.)]][5. Власюк В.В. Патология головного мозга у новорожденного и детей раннего возраста. – М.: Логосфера, 2014. [Vlasyuk VV. Patologiya golovnogo mozga u novorozhdennogo i detei rannego vozrasta. Moscow: Logosfera; 2014. (In Russ.)]][6. Korhonen U, Taipale P, Heinonen S. Assessment of bony pelvis and vaginally assisted deliveries. ISRN Obstet Gynecol. 2013;2013:763782. doi: 10.1155/2013/763782.][7. Мерц Эберхард. Ультразвуковая диагностика в акушерстве и гинекологии: перевод с английского: В 2 т. / Под ред. А.И. Гуса. – М.: МЕДпресс-информ, 2016. [Merts Eberkhard. Ul’trazvukovaya diagnostika v akusherstve i ginekologii: perevod s angliyskogo. In 2 vol. Ed by A.I. Hus. Moscow: MEDpress-inform; 2016. (In Russ.)]][8. Левин И.А., Манухин И.Б., Пономарева Ю.Н., Шуметов В.Г. Методология и практика анализа данных в медицине. – М.; Тель-Авив: АПЛИТ, 2010. [Levin IA, Manukhin IB, Ponomareva YuN, Shumetov VG. Metodologiya i praktika analiza dannykh v meditsine. Moscow; Tel-Aviv: APLIT; 2010. (In Russ.)]][9. Акушерство от десяти учителей: перевод с анг лий ского / Под ред. С. Кэмпбелла, К. Лиза. – М.: Медицинское информационное агентство, 2004. [Akusherstvo ot desyati uchiteley. Ed by S. Campbell, K. Lisa. Moscow: Medical information agency; 2004. (In Russ.)]]