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Term Breech Delivery: Does X‐ray Pelvimetry Help?
Author(s) -
Biswas A.,
Johnstone M. J.
Publication year - 1993
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1993.tb02380.x
Subject(s) - pelvimetry , breech presentation , medicine , caesarean section , apgar score , vaginal delivery , obstetrics , pregnancy , singleton , pediatrics , birth weight , pelvis , surgery , biology , genetics
Summary: Over a 3‐year period a retrospective audit was performed of all uncomplicated singleton breech presentations at term to assess the role of X‐ray pelvimetry. The review included 267 term breech presentations. Seventy‐seven women (Group A) delivered in a consultant unit where X‐ray pelvimetry was not used for decision making regarding the mode of delivery; 125 women (Group B) delivered in 2 consultant units where X‐ray pelvimetry was always used, and 65 women (Group C) delivered in a fourth consultant unit where X‐ray pelvimetry was used selectively. Obstetric outcome was measured in terms of mode of delivery. Short‐term neonatal outcome was assessed by Apgar score at 5 minutes, evidence of birth trauma and admission to the neonatal special care unit for more than 24 hours. Significantly fewer women (12.9%) had an elective Caesarean section in group A compared with the other 2 groups (27.2% in group B and 33.8% in group C; p<0.05). The vaginal delivery rates following a trial of labour were not significantly different (79.1% for group A, 65.9% for group B and 65.1% for group C) and neonatal outcome was similar in all groups. It is concluded that fewer Caesarean sections were done, without adversely affecting the neonatal outcome, when X‐ray pelvimetry was not used to select the mode of delivery of uncomplicated singleton breech presentation at term. Satisfactory progress in labour is the best indicator of pelvic adequacy.