Anthropometric predictors of cephalopelvic disproportion
Tysyachnyi O.V., Babich D.A., Baev O.R.
Background: The discrepancy between the sizes of the maternal pelvis and fetus is associated with high operative delivery rates, as well as obstetric and neonatal morbidity and mortality. The use of classical pelvimetry to predict cephalopelvic disproportion is currently considered insufficient. Evidence suggests that in the formation of a clinically narrow pelvis, the ratio of the head circumference to the maternal height plays a major role rather than the body weight of the fetus. Therefore, studying the anthropometric data of both the mother and fetus during full-term pregnancies in Russia is essential for identifying the risk groups for clinically narrow pelvises.
Objective: To investigate the prognostic significance of anthropometric data of women and fetuses at full term concerning the risk of a clinically narrow pelvis.
Materials and methods: This retrospective cohort study analyzed 12,034 delivery case records, which were divided into two groups. The study group (n=183) comprised women who underwent cesarean delivery due to a narrow pelvis, while the control group (n=915) included women who underwent vaginal delivery.
Results: The highest frequency of a clinically narrow pelvis and operative abdominal delivery was observed with a head circumference >342.15 mm and fetal body weight >3670 g. The median ratio of fetal head circumference measured by ultrasound to maternal height in the vaginal delivery group was lower, at 2.0 (1.94; 2.05), compared to 2.08 (2.02; 2.13) in the clinically narrow pelvis group (p<0.001).
Conclusion: The ratio of fetal head circumference to maternal height was lower in vaginal deliveries, measuring 2.0 versus 2.08 for the clinically narrow pelvis group. A fetal body weight of 3670 g and head circumference above 342.15 mm, as measured by ultrasound one week before the onset of labor, likely represent the threshold beyond which the probability of cephalopelvic disproportion significantly increases.
Authors' contributions: Baev O.R. – conception and design of the study; Tysyachnyi O.V. – data collection and processing, statistical analysis, visualization, drafting of the manuscript; Babich D.A. – editing of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the V.I. Kulakov NMRC for OG&P.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Tysyachnyi O.V., Babich D.A., Baev O.R. Anthropometric predictors of cephalopelvic disproportion.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (10): 53-61 (in Russian)
https://dx.doi.org/10.18565/aig.2025.160
Keywords
cephalopelvic disproportion
clinically narrow pelvis
large fetus
fetal macrosomia
cesarean section
pelvimetry
clinical discrepancy between the size of the mother's pelvis and the fetus
References
- Чернуха Е.А., Волобуев А.И., Пучко Т.К. Анатомически и клинически узкий таз. М.: Триада-Х; 2005. 256 с. [Chernukha E.A., Volobuev A.I., Puchko T.K. Anatomically and clinically narrow pelvis. Moscow: Triada-X; 2005. 256 p.(in Russian)].
- Ayenew A.A. Incidence, causes, and maternofetal outcomes of obstructed labor in Ethiopia: systematic review and meta-analysis. Reprod. Health. 2021; 18(1): 61. https://dx.doi.org/10.1186/s12978-021-01103-0
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Медицинская помощь матери при установленном или предполагаемом несоответствии размеров таза и плода. Лицевое, лобное или подбородочное предлежание плода, требующее предоставления медицинской помощи матери. 2023. [Ministry of Health of the Russian Federation. Clinical guidelines. Medical care for the mother in case of established or suspected discrepancy between the size of the pelvis and the fetus. Facial, frontal, or submental presentation of the fetus requiring medical care for the mother. 2023. (in Russian)].
- Betti L., Manica A. Human variation in the shape of the birth canal is significant and geographically structured. Proc. Biol. Sci. 2018; 285(1889): 20181807. https://dx.doi.org/10.1098/rspb.2018.1807
- Meyer R., Yinon Y., Levin G. Vaginal delivery rate by near delivery sonographic weight estimation and maternal stature among nulliparous women. Birth. 2023; 50(3): 557-64. https://dx.doi.org/10.1111/birt.12679
- Cohen G., Schreiber H., Shalev‐Ram H., Biron‐Shental T., Kovo M. Do neonatal birth weight thresholds for labor dystocia outcomes differ between short and normal stature women? Int. J. Gynecol. Obstet. 2024; 166(3): 1023-30. https://dx.doi.org/10.1002/ijgo.15139
- Dall’Asta A., Ramirez Zegarra R., Corno E., Mappa I., Lu J.L.A., Di Pasquo E. et al. Role of fetal head‐circumference‐to‐maternal‐height ratio in predicting Cesarean section for labor dystocia: prospective multicenter study. Ultrasound Obstet. Gynecol. 2023; 61(1): 93-8. https://dx.doi.org/10.1002/uog.24981
- Meyer R., Tsur A., Tenenbaum L., Mor N., Zamir M., Levin G. Sonographic fetal head circumference is associated with trial of labor after cesarean section success. Arch. Gynecol. Obstet. 2022; 306(6): 1913-21. https://dx.doi.org/10.1007/s00404-022-06472-w
- Callegari L.S., Sterling L.A., Zelek S.T., Hawes S.E., Reed S.D. Interpregnancy body mass index change and success of term vaginal birth after cesarean delivery. Am. J. Obstet. Gynecol. 2014; 210(4): 330.e1-7. https://dx.doi.org/10.1016/j.ajog.2013.11.013
- Kawakita T., Franco S., Ghofranian A., Thomas A., Landy H.J. Interpregnancy body mass index change and risk of intrapartum cesarean delivery. Am. J. Perinatol. 2021; 38(08): 759-65. https://dx.doi.org/10.1055/s-0040-1721698
- Little S.E., Edlow A.G., Thomas A.M., Smith N.A. Estimated fetal weight by ultrasound: a modifiable risk factor for cesarean delivery? Am. J. Obstet. Gynecol. 2012; 207(4): 309.e1-6. https://dx.doi.org/10.1016/j.ajog.2012.06.065
- Lipschuetz M., Cohen S.M., Israel A., Baron J., Porat S., Valsky D.V. et al. Sonographic large fetal head circumference and risk of cesarean delivery. Am. J. Obstet. Gynecol. 2018; 218(3): 339.e1-7. https://dx.doi.org/10.1016/j.ajog.2017.12.230
Received 18.06.2025
Accepted 08.10.2025
About the Authors
Oleg V. Tysyachnyi, PhD, Researcher at the 1st Maternity Department, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology,Ministry of Health of Russia, 117997, Russia, Moscow, Oparina str., 4, o_tysyachny@oparina4.ru, https://orcid.org/0000-0001-9282-9817
Dmitry A. Babich, PhD, obstetrician-gynecologist at the 1st Maternity Department, Associate Professor at the Department of Continuous Professional Education and Simulation Technologies, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia,
117997, Russia, Moscow, Oparina str., 4, d_babich@oparina4.ru, https://orcid.org/0000-0002-3264-2038
Oleg R. Baev, Dr. Med. Sci., Head of the 1st Maternity Department, V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia, 117997, Russia, Moscow, Oparina str., 4; Professor at the Department of Obstetrics, Gynecology, Perinatology and Reproductology,
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, +7(495)438-11-88, o_baev@oparina4.ru, https://orcid.org/0000-0001-8572-1971
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