Does pregnancy and/or shifting positions create more room in a woman’s pelvis?

• Published in: American journal of obstetrics and gynecology Vol. 211; no. 6; pp. 662.e1 - 662.e9
• Main Authors: Reitter, Anke, MD, Daviss, Betty-Anne, MA, Bisits, Andrew, MD, Schollenberger, Astrid, MD, Vogl, Thomas, MD, PhD, Herrmann, Eva, MD, PhD, Louwen, Frank, MD, Zangos, Stephan, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2014
• Subjects: Adult; birth; Case-Control Studies; Cohort Studies; Delivery, Obstetric - methods; Female; Humans; Magnetic Resonance Imaging; magnetic resonance imaging (MRI); maternal position; Obstetrics and Gynecology; Patient Positioning - methods; Pelvic Bones - anatomy & histology; Pelvimetry; Pelvis - anatomy & histology; Posture - physiology; pregnancy; Pregnancy - physiology; Supine Position - physiology; Tertiary Care Centers; Young Adult; magnetic resonance imaging (MRI); birth; maternal position; pelvimetry; pregnancy
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2014.06.029

Objective The purpose of this study was to assess the impact of different positions on pelvic diameters by comparing pregnant and nonpregnant women who assumed a dorsal supine and kneeling squat position. Study Design In this cohort study from a tertiary referral center in Germany, we enrolled 50 pregnant women and 50 nonpregnant women. Pelvic measurements were obtained with obstetric magnetic resonance imaging pelvimetry with the use of a 1.5-T scanner. We compared measurements of the depth (anteroposterior (AP) and width (transverse diameters) of the pelvis between the 2 positions. Results The most striking finding was a significant 0.9-1.9 cm increase (7-15%) in the average transverse diameters in the kneeling squat position in both pregnant and nonpregnant groups. The average bispinous diameter in the pregnant group increased from 12.6 cm ± 0.65 cm in the supine dorsal to 14.5 cm ± 0.64 cm ( P < .0001) in the kneeling squat; in the nonpregnant group the increase was from 12 cm ± 0.76 cm to 13.9 cm ± 1.04 cm ( P  < .0001). The average bituberous diameter in the pregnant group increased from 13.6 cm ± 0.93 cm in the supine dorsal to 14.5 cm ± 0.83 cm ( P < .0001) in the kneeling squat position; in the nonpregnant women the increase was from 12.6 cm ± 0.92 cm to 13.5 cm ± 0.88 cm ( P < .0001). Conclusion A kneeling squat position significantly increases the bony transverse and anteroposterior dimension in the mid pelvic plane and the pelvic outlet. Because this indicates that pelvic diameters change when women change positions, the potential for facilitation of delivery of the fetal head suggests further research that will compare maternal delivery positions is warranted.