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Purpose <p>Dimensions of the bony birth canal are hypothesized to be associated with pelvic organ prolapse (POP). However, the pelvic midplane, which represents the narrowest obstetrical plane, has not been thoroughly investigated. This study aims to compare the bony dimensions at the level of the pelvic midplane in childbearing women with and without POP and to evaluate their association with POP.</p> Methods <p>Data from 131 patients with POP were prospectively collected between 2021 and 2023. A total of 85 cases were matched with 85 controls who had comparable demographic characteristics. A case-control study was conducted to compare bony dimensions at the pelvic midplane level between women with and without POP using 3D MRI models. Additionally, analysis of covariance was performed to examine the relationship between these dimensions and the maximum prolapse.</p> Results <p>The comparison of dimensions (in centimeters) between 85 cases and 85 controls revealed the following significant differences: anterior–posterior diameter (11.3 ± 0.7 vs. 10.7 ± 0.7, p &lt; 0.001); pubic symphysis to ischial spine—left (9.4 ± 0.4 vs. 9.1 ± 0.4, p &lt; 0.001),—right (9.5 ± 0.4 vs. 9.1 ± 0.4, p &lt; 0.001); Ischial spine to sacrococcygeal junction—left (6.7 ± 0.5 vs. 6.5 ± 0.5, p = 0.002),—right (6.7 ± 0.5 vs. 6.5 ± 0.5, p = 0.002); interspinous diameter (11.1 ± 0.7 vs. 10.8 ± 0.7, p = 0.004); and the area of the pelvic midplane (63.0 ± 0.6 vs. 58.5 ± 0.6 cm<sup>2</sup>, p &lt; 0.001). A larger pelvic midplane was significantly associated with an increased risk of prolapse, with an odds ratio of 2.534 (95% CI 1.647–3.901, p &lt; 0.001) for every 5 cm<sup>2</sup> increase. Classification based on the presence or absence of prolapse showed that receiver operating characteristic analysis yielded an area under curve of 70.3% (p &lt; 0.001). Furthermore, among POP patients, those with a larger pelvic midplane area exhibited more severe prolapse (trend p = 0.017).</p> Conclusion <p>Women with POP have significantly larger bony dimensions at the level of the pelvic midplane compared to women without POP. Additionally, advanced prolapse is associated with larger mid-pelvic dimensions.</p>

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Bony birth canal and pelvic organ prolapse: a quantitative assessment for dimensions of pelvic midplanes based on MRI

  • 期刊论文

  • 发表日期：

    2025年5月26日

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  • Tianhang Liu,
  • Fuqing Feng,
  • Liang Shen,
  • Hao Sun,
  • Yongjie Tian,
  • Xietong Wang,
  • Aihua Li,
  • Xiaoman Hou

摘要

Purpose

Dimensions of the bony birth canal are hypothesized to be associated with pelvic organ prolapse (POP). However, the pelvic midplane, which represents the narrowest obstetrical plane, has not been thoroughly investigated. This study aims to compare the bony dimensions at the level of the pelvic midplane in childbearing women with and without POP and to evaluate their association with POP.

Methods

Data from 131 patients with POP were prospectively collected between 2021 and 2023. A total of 85 cases were matched with 85 controls who had comparable demographic characteristics. A case-control study was conducted to compare bony dimensions at the pelvic midplane level between women with and without POP using 3D MRI models. Additionally, analysis of covariance was performed to examine the relationship between these dimensions and the maximum prolapse.

Results

The comparison of dimensions (in centimeters) between 85 cases and 85 controls revealed the following significant differences: anterior–posterior diameter (11.3 ± 0.7 vs. 10.7 ± 0.7, p < 0.001); pubic symphysis to ischial spine—left (9.4 ± 0.4 vs. 9.1 ± 0.4, p < 0.001),—right (9.5 ± 0.4 vs. 9.1 ± 0.4, p < 0.001); Ischial spine to sacrococcygeal junction—left (6.7 ± 0.5 vs. 6.5 ± 0.5, p = 0.002),—right (6.7 ± 0.5 vs. 6.5 ± 0.5, p = 0.002); interspinous diameter (11.1 ± 0.7 vs. 10.8 ± 0.7, p = 0.004); and the area of the pelvic midplane (63.0 ± 0.6 vs. 58.5 ± 0.6 cm2, p < 0.001). A larger pelvic midplane was significantly associated with an increased risk of prolapse, with an odds ratio of 2.534 (95% CI 1.647–3.901, p < 0.001) for every 5 cm2 increase. Classification based on the presence or absence of prolapse showed that receiver operating characteristic analysis yielded an area under curve of 70.3% (p < 0.001). Furthermore, among POP patients, those with a larger pelvic midplane area exhibited more severe prolapse (trend p = 0.017).

Conclusion

Women with POP have significantly larger bony dimensions at the level of the pelvic midplane compared to women without POP. Additionally, advanced prolapse is associated with larger mid-pelvic dimensions.