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<) = :
1- Cunningham FG, Leveno KJ, Hauth JC, Bloom SL, Rouse DJ, Spone CY. Williams Obstetrics. 23rd .ed. cheif: MC Graw Publisher;2010.
2- Scott JR, Gibbs RS, Karlan BY, Haney AF. Danforth's Obstetrics & Gynecology. 10th .ed. philadelphia: lippincott Williams & Wilkins publisher; 2003.
3- Simkin P, Ancheta R. Labor Progress. Early Interventions to Prevent and Treat Dystocia. Translated by: Kordi M, Golmakany A. 1st .ed. Mashhad: Mashhad University Of Medical Sciences publisher: 2003. [Persian]
4- Neilson JP, Lavender T, Quenby S, Wray S. Obstructed Labour. British Medical Bulletin. 2003; 67(1): 191-2004.
5- Liselele HB, Tshibangu CK, Meuris S. Association between External Pelvimetry and Vertex Delivery Complications in African Women. Acta Obstet Gynacol Scand. 2000; 79(1): 673-678.
6- Prolonged Obstructed Labour [serial online] 2000. Available from: http://www. Who.Net.
7- Hofmery G. Obstructed Labor: Using Better Technologies to Reduce Mortality. IJGO. 2004; 1(2004):S62-S72.
8- Jamshid Beigi E. Analysis of Rural Areas's Vital Horoscop In 2001 Year [serial online] 2007 Feb: Available from:
http://www.Behdasht.gov.ir.
9- Ping zhu B, Grigorescu V, Lin M, Copeland G, Barone M, Turabelidze G. Labor Dystocia and its Association with Interpregnancy Interval. AJOG.2006;195(1): 121-8.
10- Liselele HB, Boulvain M, Tshibangu KC, Meuris S. Maternal Height and External Pelvimetry to Predict Cephalopelvic Disproportion in Nulliparous African Women: a Cohort Study . Br J Obstet Gynaecol .2000; 107(1):
947-952.
11- Rozen holc AT, Ako SN, Leke RJ, Boulvain M. The Diagnostic Accuracy Of External Pelvimetry and Maternal Height to Predict Dystocia in Nulliparous Women: A Study in Cameroon . BJOG.2007;114(1):630-635.
12- Agarwal N, Guleria K, Bansal S. Sacral Rhomboid Dimension: A New Effective Screening Parameter For Cephalopelvic Disproportion. J Obstet Gynaecol . 2003; 210(1):210-215.
13- Hamm B, Forstner R, Beinder E. MRI and CT 0f the female pelvise.1st.ed. londan: Spriger publisher; 2007.
14- Lowe Nk. A Review of Factors Associated With Dystocia and Cesarean Section in Nulliparous Women. J Midwifery Womens Health. 2007 ;52(3):216-228.
15- Ould Eljound D, Bouvier-Colle MH. Dystocia: A Study Of its Frequency and Risk Factors in Seven Cities Of West Africa. IJGO .2001; 74(1): 171-178.
16- Abolhassanzadeh A, Hekmat H. whether Iranian women's pelvic dimentions Match With those of standards or not?
Peiouhandeh Quarterly research Journal 1379; 17(5): 71-75. [Persian].
17- Muknopadhyay S, Arulkumara S. Poor Progress in Labour. Current Obstetrics & Gynaecology: 2002;12:1-2.
Abstract Original Article
The Diagnostic Accuracy of the Combination of Maternal Height and Transvers Diagonal of Michaelis Sacral Rhomboid
Area to Predict Dystocia in Nulliparous Women
M.Kordi1, R. Alijahan2,P. Pourjavad3, S. Ebrahimzadeh4, A. Mahmoudian5
Background and Aim: Detection of women at risk of dystocia could minimize the maternal and neonatal morbidity. The objective of our study was to determine The diagnostic accuracy of the combination of maternal height and transvers diagonal of Michaelis sacral rhomboid to predict dystocia in nulliparous women who referred to Ommolbanin Hospital of Mashade between December 2008 and June 2009.
Materials and Methods: In this validity study of diagnostic methods we included 447 nulliparous women with a single pregnancy in vertex presentation and with gestational age of P 38 weeks. The transvers diagonal of the Michaelis sacral rhomboid area and maternal height were assessed in cervical dilatation of Q 5 centimeters, then labor progress was monitored and dystocia was defined as caesarean section and vacuum or forceps delivery for abnormal progress of labor (at presence of effective uterine contractions, arrest of cervical dilatation or cervical dilatation less than 1 centimeter/hour in the active phase for 2 hours and duration of second stage more 2 hours or fetal head descend less than 1cm/h).
Results: Maternal height Q155 centimeters had a sensitivity of 50%, a specificity of 70/8% and an accuracy of 68/2%. The transverse diagonal of the Michaelis sacral rhomboid area Q 9/6 centimeter resulted in a sensitivity of 60/7%, a specificity of 84/1% and an accuracy of 81/2%. The highest sensitivity, specificity and accuracy were obtained from combination of maternal height tand transvers diagonal of Michaelis sacral and were respectively 89/4%, 90/7% and 86/2%.
Conclusion: Transverse diagonal of the Michaelis sacral rhomboid area in comparison to maternal height was the better predictor of dystocia and its combination with maternal height results in a better indicator for prediction of dystocia. This method could predict 86/2% of cases of dystocia and normal vaginal delivery.
Key Words: Dystocia, prolonged labor, cephalopelvic disproportion, Transverse diagonal of the Michaelis sacral, maternal height.
Journal of Birjand University of Medical Sciences. 2011; 17(3): 174- 182 Received: June 21, 2010 Accepted: November 08, 2011
1 Instructor, Faculty of Nursing and Midwifery, Mashhad University of Medical sciences, Iran.
2 . Corresponding Author, master of sience midwifery, clerk of Ardabil health center, Iran. [email protected] 3 Department of Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran
4 Department of Statistics, Mashhad University of Medical Sciences, Mashhad, Iran 5 Department of Anatomy, Mashhad University of Medical Sciences, Mashhad, Iran
