Evaluation of maternal anthropometric measurements to predict cephalopelvic disproportion in nulliparous women in rural Meghalaya

Abstract

Objective: The study evaluates the effectiveness of maternal anthropometric measurements of our population with estimated fetal weight as an additional parameter to predict Cephalopelvic disproportion (CPD). Materials and Method: The prospective study conducted in a tertiary care center involved 353 primigravida over 37 weeks of gestation with singleton pregnancy admitted at Nazareth hospital, Shillong, Meghalaya, India. Anthropometric measurements included maternal height, bis-acromial diameter, foot length, estimated fetal weight and vertical and transverse rhomboid diameters. Based on mode of delivery, patients were divided into two groups - CPD group and No CPD group. Results: Out of 353 patients, 141 (40%) had CPD and 212 (60%) had no CPD. High positive predictive values for CPD was demonstrated for maternal height, foot length, bis-acromial diameter and rhomboid dimensions. The risk factors predicted for CPD in this study were height ≤142 cm, foot length ≤20cm, Bis-acromial diameter ≤ 32.5 cm, Michaelis rhomboid - transverse and vertical diameters ≤9 cm and 9.5 cm, respectively, and estimated fetal weight ≥3255 gm. Conclusion: Generally, the women in this region are of short stature with an average height of 142 cm. The anthropometric measurements of this population vary from the other populations accordingly. Hence, knowledge of these parameters and their usage will help in early CPD anticipation and timely referral of these patients to tertiary centers. Measuring maternal and fetal parameters is easy and a reproducible skill that can be transferred to midwives in the rural area for better antenatal care.