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Determining the accuracy of three-dimensional (3D) sonographic measurement of symphysis pubis (SP) distension in comparison to plain X-ray pelvic radiographs and assessing the interperformer reliability of this method.

Pelvic X-ray was performed on 86 women who delivered singleton babies within 36 h of delivery then each woman was examined by 3D transperineal ultrasound imaging by two sonogrographers.

Measurements of SP with 3D transperineal ultrasonography in comparison to pelvic X-ray showed 95% limits of agreement. Interperformer reproducibility was substantial (interclass correlation coefficient 0.66–0.70) for measures of SP.

Pubic symphysis width, superior pubic ligament length, and SP height can be reliably measured with 3D ultrasonography.