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骨盆测量在产程积极管理中的作用。

Role of pelvimetry in active management of labour.

作者信息

Joyce D N, Giwa-Osagie F, Stevenson G W

出版信息

Br Med J. 1975 Nov 29;4(5995):505-7. doi: 10.1136/bmj.4.5995.505.

Abstract

All cases referred for pelvimetry in 1970-1 and all breech presentations referred for pelvimetry in 1972-4 were reviewed. Indications for pelvimetry fell into four main categories: high head in the antenatal clinic (47-8%); high head in labour (13-9%); breech presentation (20-9%); and previous caesarean section (14-8%). In the first two categories pelvimetry rarely if ever influenced management, and it should not be performed routinely. In breech presentation and cases of caesarean section pelvimetry seemed to be of value, but in the latter group it should be performed puerperally to avoid the known radiation hazard to the fetus. A fairly close correlation between obstetric conjugate and pelvic capacity was shown, which suggested that a 3400-g baby might pass through a pelvis of obstetric conjugate of 10 cm as a cephalic trial of labour, but would need an obstetric conjugate of 11-7 cm for safe vaginal breech delivery.

摘要

对1970 - 1年所有因骨盆测量前来就诊的病例以及1972 - 4年所有因臀位前来进行骨盆测量的病例进行了回顾。骨盆测量的指征主要分为四类:产前检查时头高(47 - 8%);分娩时头高(13 - 9%);臀位(20 - 9%);以及既往剖宫产史(14 - 8%)。在前两类中,骨盆测量极少影响处理决策,不应常规进行。在臀位和剖宫产病例中,骨盆测量似乎有价值,但对于后一组病例,应在产后进行以避免已知的对胎儿的辐射危害。结果显示产科结合径与骨盆容量之间存在相当紧密的相关性,这表明体重3400克的胎儿作为头位试产时可能通过产科结合径为10厘米的骨盆,但安全经阴道臀位分娩则需要产科结合径为11 - 7厘米。

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本文引用的文献

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A survey of childhood malignancies.一项儿童恶性肿瘤调查。
Br Med J. 1958 Jun 28;1(5086):1495-508. doi: 10.1136/bmj.1.5086.1495.
3
Prevention of prolonged labour.预防产程延长。
Br Med J. 1969 May 24;2(5655):477-80. doi: 10.1136/bmj.2.5655.477.
4
Active management of labour and cephalopelvic disproportion.
J Obstet Gynaecol Br Commonw. 1970 May;77(5):385-9. doi: 10.1111/j.1471-0528.1970.tb03539.x.

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