Prediction of labour outcomes in short stature women using pelvimetry

• Research type

  Research Study

• Full title

  Assessing MRI and ultrasound pelvimetry for the prediction of labour dystocia in short stature primigravidae: a pilot study

• IRAS ID

  289843

• Contact name

  Robert Freeman

• Contact email

  robert.freeman@nhs.net

• Sponsor organisation

  University Hospitals Plymouth NHS Trust

• Duration of Study in the UK

  0 years, 6 months, 2 days

• Research summary

  
  Delayed progress in labour, also known as labour dystocia is the leading cause of interventions during labour and delivery and a significant cause of morbidity. This includes in-labour caesarean section, shoulder dystocia, obstetric anal sphincter injuries, long-term pelvic organ prolapse, and urinary incontinence. Until recently, the relationship between maternal height and labour dystocia has not been thoroughly explored. Short maternal height, defined as women less than 158cm in height, is associated with labour dystocia due to an increased likelihood of disparity between fetal head size and maternal pelvic diameters. In those with an ‘adequate pelvis’ vaginal delivery might be successful and without complication, but without objective assessment of pelvic size that cannot be predicted.

  Within the NICE caesarean section guidelines, no distinction is made between the management of short stature and taller women i.e. a trial of labour for both. They state “pelvimetry is not useful in predicting ‘failure to progress’ in labour and should not be used in decision making about mode of birth”. This blanket strategy results in a high rate of in-labour CS for short stature women, independent of birthweight. Providing such at- risk women with advice about the risks of vaginal delivery might lead to more requests for caesarean section; this could be avoided by specifying individual risk based on pelvic dimensions.

  The aim of this study is to assess the usefulness and reliability of MRI and US pelvimetry in determining labour outcomes in short stature women.
  

• REC name

  West of Scotland REC 3

• REC reference

  21/WS/0013

• Date of REC Opinion

  11 Mar 2021

• REC opinion

  Further Information Favourable Opinion