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Topic: THE PREVALENCE OF PELVIC INDEX IN RIVERS STATE POPULATION AS MEASURED FROM RADIOGRAPH

Ref.Code: UPW-PT-0a68f8864eInstitution: UNIPORT

ABSTRACT The study carefully examined the pelvic index as measured from the radiograph of Rivers State, Nigerian males and females. The study was carried out randomly, using a total of 200 Antero-posterior radiographs of the pelvis of 135 females and 65 males that were collected from the department of radiology, University of Port Harcourt Teaching Hospital (UPTH). Only cases free from fracture were selected and analyzed. All pelvis had been classified using Tunner’s method of pelvis classification based on pelvic index. Pelvic index above 95 are known as Dolichopellic index, pelvic index below 90 are known as Platypellic index and pelvic index ranging from 90-95 are known as Mesatipellic index. A total of 53% had Dolichopellic index, 35.5% had Platypellic index and 11.5% had Mesatipellic index. The result revealed a significant prevalence in the rate of Dolichopellic index between both sexes of the population. The mean pelvic index for the population is 25.00 while the standard deviation is (SD:18.50), the mean for the males and females Anterio-posterior diameter are 16.25 (SD: 8.99) and 27.00 (SD: 18.86), the mean for the Transverse diameter are 16.25 (SD: 15.33) and 27.00 (SD: 27.92) while the mean for the males and females of the entire population are 9.29 (SD: 4.309)and 19.14 (SD: 13.86). The difference between the males and females means of the pelvic indices is statistically non-significant (p>0.05). Finally, the prevalence of pelvic index with respect to this research work is Dolichopellic, also this work will be useful to Obstetricians, Anthropologists and Radiologistsin medical practices.
TABLE OF CONTENT

Pages
Title i
Declaration ii
Dedication iii
Acknowledgement iv
List of Tables v
Abstract vi
Table of content vii - viii
CHAPTER ONE:
Introduction ……………………………………………………………………………………………….1
1.1 Aim and objective ……………………………………………………………………………………….4
CHAPTER TWO:
Literature review …………………………………………………………………………………………6
2.1 Osteology of the pelvis ……………………………………………………………………………….18
2.1.1 Pelvic girdle ………………………………………………………………………………………………..20
2.1.2 Pelvic cavity ………………………………………………………………………………………………..23
2.1.3 Vasculature and nerves of the pelvis …………………………………………………………..24
2.1.4 Pelvic viscera ………………………………………………………………………………………………25
2.1.5 Pelvic joint and ligament …………………………………………………………………………….25
2.2 Pelvic index ………………………………………………………………………………………………. .25
2.2.1 Classification of pelvic index ……………………………………………………………………….26
2.2.2 Pelvic diameters ………………………………………………………………………………………….26
2.3 Classification of pelvis ………………………………………………………………………………….27
CHAPTER THREE:
3.0 Materials and method …………………………………………………………………………………30
3.1 Sample population ………………………………………………………………………………………30
3.2 Study site …………………………………………………………………………………………………….30
3.3 Ethical clearance ………………………………………………………………………………………….30
3.4 Sample size ………………………………………………………………………………………………….30
3.5 Inclusion and exclusion criteria ……………………………………………………………………30
3.6 Study materials ……………………………………………………………………………………………30
3.7 Procedure/method ……………………………………………………………………………………..32
3.7.1 Sample collection ……………………………………………………………………………………….32
3.72 Measurement ………………………………………………………………………………………………33
3.8 Statistical analysis ………………………………………………………………………………………..33
3.9 Limitation of procedure and research ………………………………………………………….34
CHAPTER FOUR:
4.0 Result and data analysis ………………………………………………………………………………35
CHAPTER FIVE:
5.0 Discussion ……………………………………………………………………………………………………40
5.1 Conclusion …………………………………………………………………………………………………..43
5.2 Recommendation ………………………………………………………………………………………..43
REFERENCE
APPENDIX
CHAPTER ONE
INTRODUCTION
Pelvic index is gotten from the measurement of two diameters of the pelvic inlet of the pelvic bone. These diameters are Antero-posterior and Transverse diameters which are gotten during Pelvimetry.
Pelvimetry is the measurement of the dimensions and capacity of the pelvis especially of the adult female pelvis. This could either be done by manual (cadaver) or radiographical method using Radiograph. Many studies have expose pelvimetry as a reliable source of the ability to give birth via virginal.
Clinical Pelvimetry is a clinical procedure for assessing the capacity of the pelvis through the detection of bony abnormality and ruling out disproportion by relating the foetal head to the maternal pelvis. It is mostly performed at the 36th week of pregnancy at the time which the pelvic soft tissue are fully relaxed or dilated and the foetal head achieve optimal growth. This is done manually by examining the pelvis and palpating the pelvic bone by vagina examination. The entire bone arch of the maternal pelvis including the Sacrum, sacrococcygeal joint, sacro -sciatic notch, ischial spine, illiopectineal and the pubic arch are all palpated and an assessment of the size of the pelvis is made. The diameters of pelvis are measured with the index and middle fingers of the hand.
A normal pelvis on clinical pelvimetry suggests that a normal foetus presenting with head in an attitude of flexion during delivery will pass through easily with good contraction.
A contracted or border line pelvis may arouse suspicion that labour may be difficult. Similarly, even with an apparently adequate pelvis, lack of strong sustained contraction at the essential and critical period in labour may allow poor flexion and malposition or abnormal position of the foetal head which may present a much wider diameter to the pelvis to cause relative cephalopelvic disproportion (CPD). (Akin, 2006)
Radiographical pelvimetry is used to confirm the presence or absence of disproportion but it must never be thought that it can replace or take the place of clinical pelvimetry.
X-ray measurements of pelvic diameter may be more accurate than clinical measurements but it must clearly be recognized that accurate prediction of the outcome of labour cannot be made in every case. (Humphery,1949)
However, the precise measurements of the pelvis and foetal head may be gotten using this method. X-ray are taken in different angles and viewed where the pelvic diameter such as the Antero-posterior, Transverse and Diagonal diameters are measured. All cases of inadequate pelvis on clinical pelvimetry are followed by X-ray pelvimetry for precise measurement which provides more accurate relationship of the foetal head to the pelvis. Usually X-ray pelvimetry is done at about 36th week of gestation and in current obstetric practice it is commonly a single view called Lateral X-ray pelvimetry. (Barron et al 1964)
This view provides all the information required for the confirmation of contracted pelvis. Aside from being used as a back-up to further asses, a finding of inadequate pelvis on Clinical Pelvimetry, X-ray Pelvimetry is indicated in some other circumstances such as:

Pelvic abnormality
Malpresentation of foetus like in Breech
Previous prolong labour
Previous caesarean section
Suspected cepahlopelvic or foetal pelvic disproportion
Recently, the use of modern radiographic technique such as computerized tomography scan (CT) and magnetic resonance imaging (MRI) have been reported as more reliable tool for pelvimetry examination than X-ray films. The use of CT scanning is preferred to the conventional radiography and can be justified on the basis of easy performance, interpretation and decreased foetus exposure to radiation. It is also possible to evaluate the foetal line and position with the computerized tomography scanning. magnetic resonance imaging (MRI) has the same advantage plus the lack of ionizing radiation. In addition, it has a higher resolution and contrast than CT scan but is contraindicated in patients with a metal prosthesis. At present there has been no deleterious effect of the foetus caused by the use of MRI. (Stefan et al, 2002)
In all situations, the X-ray pelvimetry finding in combination with the clinical pelvimetry significantly influences the decision to allow or disallow vagina birth delivery.


1.1 REASONS FOR RESEARCH
To know the kind (prevalence) of pelvic that persists amongst people of this region.
To checkwhether x-ray measures of the pelvis can be used to predict cesarean
delivery.
To know the sexual dimorphism among the female pelvis for parturition purpose.
1.2 AIM AND OBJECTIVE
The study focuses on the measurement and evaluation of pelvic index among males and females of Rivers State Population (Nigeria).
To determine the prevalence and how common a particular form of pelvic index occur in the region using dimension (Antero-posterior and Transverse diameters) of the bony pelvis on a radiograph of both sexes (Male and Female).
To determine the difference betweenmale and female Pelvic index in the University of Port Harcourt Teaching Hospital.
To determine the average pelvic index for males and females.

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