15 marzo 2014

I Pavimenti Pelvici non sono tutti uguali

Lo studio che ho trovato in internet è davvero interessante poichè confronta il pavimento pelvico di americane di origine africana e americane di origine europea. Sono stati confrontati 40 + 40 bacini pelvici. Le distanze tra i punti di ancoraggio del pavimento pelvico verso la parte ossea della pelvi sono state misurate in tutte le donne. Si è tenuto conto dell’altezza delle donne. Le donne americane di origine africana hanno il pavimento pelvico del 5,1% più piccolo delle americane di origine europea. Questo comporta maggiori rischi di parti distocici, complicati, ma meno disturbi dovuti ad eccessiva lassità dei muscoli del pavimento pelvico (es. prolassi), poichè l’area di muscolatura è nettamente inferiore. Obiettivamente le disfunzioni urinarie interessano maggiormente le donne europee occidentali che le africane ad esempio.


Objective: This study tests the null hypothesis that the size of the pelvic opening spanned by the pelvic floor is the same in African American and European American women. Study Design: Forty African American female pelvises were age matched with 40 European American female pelvises from the Hamann-Todd collection at the Cleveland Museum of Natural History. The distances between the anchoring points of the pelvic floor to the bony pelvis (pubis anteriorly, ischial spines laterally, and inferior lateral angle of the sacrum posteriorly) were measured on each half of the pelvis. Measurements from left and right halves were averaged. The cross-sectional area of the pelvic floor was calculated from these dimensions. The bi-ischial line divided the total area into anterior and posterior pelvic floor areas. Analyses taking into account differences in stature by dividing individual dimensions by height were also performed. Group differences were compared with the Student t test and the Mann-Whitney rank sum test. Results: African American women had a 5.1% smaller pelvic floor area than European American women (889.6 cm2 vs 937.0 cm2, 5.1% P =.037). This was attributable to a 10.4% smaller posterior area (365.3 cm2 vs 407.6 cm2, 10.4% P =.016), whereas the anterior areas were similar (524.3 cm2 vs 529.3 cm2, P =.61). The following measured distances were smaller in African American women: ischial spine to inferior sacral angle (5.4 cm vs 5.9 cm, P =.016) and bi-ischial diameter (10.0 cm vs 10.6 cm, P =.004). These distances remained significant after height was controlled. Conclusions: In African American women, the posterior pelvic floor area is 10.4% smaller than in European American women, resulting in a 5.1% smaller total pelvic floor area. (Am J Obstet Gynecol 2002;187:111-5.)


Bibliografia: Presented at the Twenty-Second Annual Meeting of the American Urogynecologic Society, Chicago, Ill, October 25-28, 2001
BSa J.O.L. DeLancey, MDb R. Caspari, PhD D.H. Howard, MPH, MD J.A. Ashton-Miller



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