The anterior iliac separation: alternative index for pelvic morphometry in fetuses with Down syndrome

The goal of this study was to assess the diagnostic use of an anterior iliac separation measurement as an alternative index for the iliac angle in the assessment of fetal pelvic morphometry.

In 358 fetuses, the anterior iliac separation, iliac length, and iliac angle were prospectively measured on antenatal sonography. All measurements were obtained at two axial levels (superior and inferior). The gestational age of the fetus was recorded. The anterior iliac separation was normalized by iliac length, and coefficients of variation were calculated for all measurements. The effects of axial level and gestational age were assessed in a linear regression model. The diagnostic use of the anterior iliac separation relative to that of the iliac angle was assessed in a comparison of 24 fetuses with Down syndrome and 247 non-Down syndrome fetuses.

The anterior iliac separation was less variable than the iliac angle at both superior and inferior levels. There were statistically significant effects for gestational age and axial level on both the anterior iliac separation and the iliac angle, but there was no significant effect for either factor when the anterior iliac separation was normalized by the iliac length. Comparing Down and non-Down syndrome fetuses, we found that the normalized anterior iliac separation had discriminating power similar to the iliac angle.

The linear measurement of the anterior iliac separation has diagnostic properties similar to the iliac angle and is subject to less measurement variability. This simpler measurement may be particularly useful when normalized by the iliac length.