*5.2.1 Pelvic measurements in multiparae and nulliparae in the Southern Province of Rwanda*

Huye District in the Southern Province of Rwanda served as the framework of a cross-sectional and analytical study in nulliparae (*n* = 312) and multiparae (*n* = 314) at prenatal care settings on randomly fixed days from December 2007 to January 2008. Pelvic measurements were taken and average pelvic sizes in multiparae who have always delivered per vaginam were compared to those in nulliparae (Student's *t* test). The aim of the study was to describe and characterise external pelvic parameters in Rwandan pregnant women in a rural area. Average sizes were significantly greater in multiparae than in nulliparae except for the intertrochanter diameter and the base of the Trillat's triangle (**Table 1**). These preliminary findings suggested the fact that external pelvic diameters of multiparous women without previous caesarean experience would belong to pelvises best suited for delivery. It is worth noting that measurements in both multiparae and nulliparae were normally distributed (Kolmogorov-Smirnov test) [58].


#### **Table 1.**

*Comparison of pelvic diameters between Rwandan multiparae and nulliparae in the Southern Province.*

**79**

**Table 3.**

**\****Student's t test.*

**Table 2.**

*Safe Childbirth and Motherhood in African Great Lakes Region: External Pelvimetry…*

*5.2.2 Pelvic measurements in multiparae and nulliparae in Kigali City/Rwanda*

*5.2.3 Pelvic measurements in multiparae and nulliparae in DRC*

**Pelvic measurements (cm) Multiparae (***N* **= 938)**

*Pelvic measurements in multiparae and nulliparae in DRC.*

*Comparison of pelvic diameters between Rwandan multiparae and nulliparae in Kigali city.*

**Diameters (cm) Multiparae (***N* **= 318)**

A descriptive cross-sectional study as part of a large research project in the city of Lubumbashi was carried out from February 2016 to August 2017 in nulliparae (*n* = 535) and multiparae (*n* = 938) on pelvic and anthropometric parameters. Data were collected at antenatal clinics and admission to delivery rooms in seven maternities. The aim of the study was among others to profile external pelvic sizes in nulliparae and multiparae who used to give birth naturally. At first glance, external pelvic diameters sizes showed also a greater or lesser difference between Congolese multiparae and nulliparae in Lubumbashi (**Table 3**). The same deduction made about pelvis suitability for Rwandan women could also be applied to Congolese women [60].

**Mean ± SD**

Intercrestal 26.02 ± 2. 17 24.69 ± 2.28 Interspinous 22.94 ± 2. 37 21. 79 ± 3.78 Intertrochanteric 29.81 ± 2.72 29.26 ± 2.98 Intertuberous 10.22 ± 0.94 9.77 ± 1.51 Anteroposterior 20.22 ± 1.32 19.94 ± 1.92 Base of Trillat's triangle 13.04 ± 1,31 13.00 ± 1.82

A cross-sectional and analytical study was also carried out in Kigali City (Kigali University Teaching Hospital and Muhima District Hospital) from May 2009 to June 2010 in nulliparae (*n* = 318) and multiparae (*n* = 303) at admission in delivery rooms. One of the specific objectives of the study was also to describe and characterise pelvic and anthropometric parameters in Rwandan pregnant women in an urban area. Student's t test was used to compare average values observed in multiparae and nulliparae. Average sizes in multiparae who never experienced caesarean section were also significantly greater than in nulliparae for all considered pelvic diameters (**Table 2**). The same abovementioned implication about pelvis suitability in multiparae was suggested while average pelvic sizes in both multiparae and nulliparae were smaller in rural women from the rural area (Southern Province) than in their urban counterparts (Kigali City). Nutritional status was suggested as the factor that would explain this difference [59].

**Mean ± SD**

Intercrestal 26.58 ± 0.01 24.33 ± 0.16 0.327 Interspinous 24.04 ± 0.09 23.73 ± 0.17 0.014 Intertrochanteric 29.09 ± 0.13 28.88 ± 0.20 <0.001 Intertuberous 12.90 ± 0.10 12.25 ± 0.13 <0.001 Anteroposterior 18.62 ± 0.18 18.14 ± 0.12 <0.001 Base of Trillat's triangle 15.27 ± 0.10 14.39 ± 0.13 <0.001

**Nulliparae (***N* **= 303) Mean ± SD**

*p***\***

**Nulliparae (***N* **= 535) Mean ± SD**

*DOI: http://dx.doi.org/10.5772/intechopen.89638*

*Safe Childbirth and Motherhood in African Great Lakes Region: External Pelvimetry… DOI: http://dx.doi.org/10.5772/intechopen.89638*
