MVPelviStudie: Anthropologische Betrachtung des weiblichen Beckens für geburtshilfliche und urogynäkologische Fragestellungen

Elger, Luisa Josephine (2026): MVPelviStudie: Anthropologische Betrachtung des weiblichen Beckens für geburtshilfliche und urogynäkologische Fragestellungen: geburtshilfliche Aspekte. Dissertation, LMU München: Faculty of Medicine

Abstract

In this observational study, a novel three-dimensional (3D) method was employed to as-sess pelvic dimensions and their impact on the mode of delivery. The 3D pelvic morphology of women who had undergone vaginal delivery, cesarean sections, and nulliparous women was collected to identify differences in pelvic features among these groups. Additionally detailed obstetric history, including fetal and maternal characteristics, was collected and compared with the birth register data of the University Hospital of the Ludwig-Maximillians-Universität (LMU) München for validation. The study population comprised women aged 50 and above who underwent a computed tomography (CT) scan for any medical reason. The bony pelvis was extracted and reconstructed in 3D, with 274 landmarks placed on each surface model for a precise measurement. Following the application of the exclusion crite-ria, namely the presence of foreign material in the bony pelvis, an unknown birth mode, exclusively preterm births and women who had undergone both a vaginal birth and a cae-sarean section, the remaining 206 participants were selected for further analysis. A total of 177 women were divided into three groups based on their obstetric history, as reported via a questionnaire: 118 women who had only undergone vaginal births, 21 women who had only undergone caesarean sections, and 38 nulliparous women. Pelvic inlet measurements, utilizing 32 landmarks, revealed a significantly smaller (p = 0.002) area of the pelvic inlet in the cesarean section group (mean = 126.3 cm²) compared to the vaginal birth group (mean = 134.9 cm²). Nulliparous women served as a control group and showed no statisti-cally significant difference in the pelvic inlet area compared to the vaginal birth group. No significant differences in maternal and fetal characteristics were observed among the birth groups. The 19.4 % cesarean section rate aligned with the one of the LMU birth register data (20.3 %). The method of placing 274 landmarks on a 3D reconstructed bony pelvis allowed for the precise pelvic morphology measurement, particularly in assessing the pelvic inlet area. The trial was registered at the German Clinical Trials Register DRKS (DRKS00017690).

• Item Type: Theses (Dissertation, LMU Munich)
• Subjects: 600 Technology, Medicine; 600 Technology, Medicine > 610 Medical sciences and medicine
• Faculties: Faculty of Medicine
• Language: German
• Date of oral examination: 18. March 2026
• 1. Referee: Hasbargen, Uwe
• Signature of the printed copy: 0700/UMD 22740