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Int J Obstet Anesth · Apr 2013
Does body mass index influence the degree of pelvic tilt produced by a Crawford wedge?
- N L Harvey, R L Hodgson, and S M Kinsella.
- Department of Anaesthesia, St Michaels Hospital, Bristol, UK. nicola.harvey@uhbristol.nhs.uk
- Int J Obstet Anesth. 2013 Apr 1;22(2):129-32.
BackgroundA pelvic tilt of 15° is standard practice when positioning a woman for caesarean section, and is commonly produced by tilting the operating table or placing a wedge under the right hip. This study investigated whether body mass index affects the degree of pelvic tilt produced when a wedge is used.MethodsWomen undergoing category 3 and 4 caesarean sections were stratified into three groups according to their body mass index at antenatal booking: ≤ 25kg/m(2), 25.1-35kg/m(2) and >35kg/m(2). Twenty women were recruited into each group. Lateral tilt at caesarean section was provided with a Crawford wedge under the right hip and the degree of pelvic tilt was measured using a protractor device.ResultsThe median [range] pelvic tilt angle for the groups in order of ascending body mass index were 15° [12-22°], 19° [11-29°] and 17° [2-28°]. There was a significant increase in the variability of pelvic tilt with increasing body mass index (P=0.001). The proportion of patients with pelvic tilt <15° was observed to be 20%, 15% and 30% for women of body mass index ≤ 25kg/m(2), 25.1-35kg/m(2) and >35kg/m(2), respectively.ConclusionVariability in pelvic tilt increased with body mass index and was greatest with a booking body mass index >35kg/m(2).Copyright © 2012 Elsevier Ltd. All rights reserved.
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