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MR Pelvimetry for Breech Presentation at Term- Interobserver Reliability, Incidental Findings and Reference Values.

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Summary

Magnetic Resonance (MR) pelvimetry is a reliable method for assessing vaginal breech delivery viability, showing strong interobserver agreement. Conjugata vera measurements help identify fetopelvic disproportion, while incidental findings are common.

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Area of Science:

  • Radiology
  • Obstetrics
  • Medical Imaging

Background:

  • Antepartal MR pelvimetry is crucial for evaluating vaginal breech delivery suitability.
  • Assessing the reliability of MR pelvimetric measurements and incidental findings is important for clinical practice.

Purpose of the Study:

  • To evaluate the reliability of MR pelvimetric measurements and incidental findings.
  • To assess potential reference values for MR pelvimetry in singleton breech pregnancies.

Main Methods:

  • A monocentric study included 99 obstetric MR pelvimetries of singleton breech pregnancies (1999-2016).
  • Six observers with varying experience levels independently reviewed images, assessing conjugata vera (CV) and diameter transversalis (DT).
  • Image quality, incidental findings, and obstetric data were analyzed for reference value assessment.

Main Results:

  • Strong interobserver agreement was observed (Intraclass Correlation Coefficient: 0.889–0.968).
  • Conjugata vera measurements were significantly smaller in the recommended cesarean section group (p < 0.0001).
  • 134 incidental findings were noted, with radiologic expertise vital for their appraisal.

Conclusions:

  • MR pelvimetry demonstrates high reliability, irrespective of the reader's experience level.
  • Conjugata vera measurements are valuable for prepartal assessment of vaginal breech delivery viability.
  • Incidental findings during MR pelvimetry are relatively common and require expert interpretation.