Antepartum pelvimetry by magnetic resonance imaging

Abstract

Evaluation of the pelvis by pelvimetry plays an important role in selecting patients for possible vaginal delivery. However, x-ray pelvimetry involves the disadvantage of fetal exposure to ionizing radiation. The clear advantage of magnetic resonance imaging (MRI) pelvimetry is that this procedure is free from ionizing radiation. Measurements with MRI are as reliable as those with x-ray pelvimetry and the contrast of MRI is even better. MRI shows soft-tissue structures as well as bone. The use of this scanning technique is contraindicated for patients with pacemakers. But, pacemakers are rarely encountered in young pregnant women. In our department, 203 patients underwent antepartum pelvimetry with MRI during the last 5 years. T1-weighted mediosagittal images were used for measurement of the obstetric conjugate (OC) and to determine whether a straight sacrum can be recognized. Data were compared between patients who had undergone cesarean section due to cephalopelvic disproportion (CPD) and patients who experienced vaginal delivery. OC and OC-biparietal diameter were significantly different between the two groups. MRI can be further used for the diagnosis of CPD and to select patients for whom planned vaginal delivery is appropriate.