clinical pelvimetry

clinical pelvimetry

a process used to assess the size of the birth canal by means of the systematic vaginal palpation of specific bony landmarks in the pelvis and an estimation of the distances between them. Internal pelvic diameters are not accessible to direct measurement; they must be inferred. Clinical pelvimetry is usually performed by a midwife or an obstetrician during the first prenatal examination of a pregnant woman. Findings are commonly recorded in terms such as adequate, borderline, or inadequate, rather than in centimeters or inches. Compare x-ray pelvimetry. See also birth canal, cephalopelvic disproportion, contraction, dystocia.
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Examples: Asking whether clinical pelvimetry was documented in the chart of a multiparous woman who came in actively laboring, or asking if fundal height was measured in the office during a patient's last three prenatal visits.
Parity (nulliparous vs parous) and findings from clinical pelvimetry were the two most important factors.
Clinical pelvimetry was customarily recorded at the initial examination.
Smokers, single women, those with anemia, obesity, or poor nutrition, and those with small or borderline findings on clinical pelvimetry were more likely to plan hospital births (data not shown).
Clinical pelvimetry made the largest contribution, in keeping with the high proportion of intrapartum transfers due to arrests of labor.
When the same analysis was performed for multiparas, only 16% of whom required delivery in the hospital when they had planned otherwise, clinical pelvimetry was no longer important.
Potential bias remains, however, in the recording of some items requiring subjective judgment such as patient requests, length of labor, blood loss, and possibly Apgar scores and clinical pelvimetry.
These data, however, suggest that clinical pelvimetry may be useful for predicting intrapartum transfers that result from abnormal labor progress.

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