[Evaluation of the iliac crest as anatomic landmark for spinal anaesthesia in pregnant women].
OBJECTIVE
Estimate the relevance of the Tuffier line, which connects both iliac crests, in analyzing the location of the puncture point for spinal anaesthesia for pregnant women.


METHODS
Prospective.


METHODS
The age, weight, height, body mass index (BMI) and uterine height, (HU) of 121 patients admitted in the delivery room in July 2005, were recorded. The intersection point of the Tuffier line with the rachis was recorded in seating and sleeping positions. The corresponding vertebral level was verified by counting spiny apophyses from C7.


RESULTS
The Tuffier line crossed the spine at the expected level for 29.7% of the patients. The intersection point was below the expected in 6.6% of the cases and above in 63.7% of the cases. Only the weight and the BMI were significantly connected with stronger probability of error (p=0.001).


CONCLUSIONS
The error level with this method is important and comparable to error level in the series published in patients who are not pregnant woman. The main risk is the spinal injury, since the level of ending of the spinal cord is variable. It seems safe to use another method of location, especially with patients experiencing excessive weight.
Service d'Anesthésie-Réanimation, Maternité Souissi, CHU de Rabat-Salé, 10100 Rabat, Maroc. ali_kettani@hotmail.com
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Kettani
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Tachinante
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Tazi
D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D000886:Anthropometry / Q000379:methods*; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D006801:Humans; D007085:Ilium / Q000033:anatomy & histology*; D009765:Obesity / Q000473:pathology; D011187:Posture; D011247:Pregnancy; D011248:Pregnancy Complications / Q000473:pathology; D011446:Prospective Studies; D012016:Reference Values; D013131:Spine / Q000033:anatomy & histology*