Comparison of Michaelis Rhombus, Height and Foot Length of Patient in Prediction of Mode of Delivery

Abstract

Background: The Michaelis rhombus, a diamond-shaped area in the lower back is easy to measure. During labor it is thought to move posteriorly, pushing out the wings of the ileum and increasing the diameter of the pelvis. Comparison of Michaelis Rhombus, height and foot length of patient in has been used as a simple means to identify women at risk of cephalo-pelvic disproportion and help in prediction of a safe mode of delivery. Aim and Objective: The present study was conducted to evaluate the Michaelis rhombus as predictor of contracted pelvis and to compare its efficacy to other measures like maternal height and foot length of labouring and or antenatal mothers.  Method: This is a Prospective Observational comparative study conducted on 220 antenatal pregnant women who were admitted at the Department of Obstetrics and Gynaecology, R. D. Gardi Medical college and C.R.G. Hospital, Surasa, Ujjain (M.P.), India. This study was carried out on pregnant women in the age group of 19-35 years, which were coming for delivery in our hospital with gestational age >36 weeks. Result: Out of 220 subjects 190 delivered by normal delivery and 30 subjects by LSCS. Transverse diagonal was significantly lower in LSCS mean 9.53±0.69 cm as compared to normal delivery where transverse diagonal [mean 10.59±0.55 cm] (p = 0.000). Vertical diagonal was lower in LSCS cases (mean 10.73±0.87 cm) as compare to normal delivery where vertical diagonal (mean 11.94±0.73 cm). Foot length was significantly lower in LSCS cases with mean 23.12±1.28 cm as compared to normal delivery with mean 24.48±1.05 cm. Height was significantly lower in LSCS cases with mean 148.23±5.56 cm as compared to normal delivery with mean 153.94±3.31 cm. Conclusion: Anthropometric parameters like Michaelis rhombus, height, foot length can be used as predictor of contracted pelvis. These measurements help to increase ease of patient for clinical assessment of pelvis by decreasing multiple per vaginal examination, thereby decreasing chances of infection.