Krishnamurthy S, Fairlie F, Cameron A D, Walker J J, Mackenzie J R
Perinatal Research Unit, Glasgow Royal Maternity Hospital, Rottenrow.
Br J Obstet Gynaecol. 1991 Jul;98(7):716-8. doi: 10.1111/j.1471-0528.1991.tb13462.x.
The purpose of this study was to investigate the influence of postnatal x-ray pelvimetry after caesarean section on the management of the subsequent pregnancy. The case records of 331 women delivered by casearean section in their first pregnancy were reviewed. By standard radiological criteria, the pelvis was considered to be inadequate in 248 (75%) of them and adequate in 83 (25%). Of the women with a radiologically inadequate pelvis, 172 underwent an elective caesarean section. Seventy-six were allowed vaginal delivery: 51 of these women delivered vaginally and 25 required an emergency caesarean section. Of the women with a radiologically adequate pelvis, 61 achieved a vaginal delivery and 22 were delivered by caesarean section. All of the three cases of uterine rupture occurred in women with a radiologically adequate pelvis. This study suggests that x-ray pelvimetry is not a good predictor of the outcome of a trial of vaginal delivery. We conclude that the practice of routine postnatal pelvimetry should be abandoned.
本研究的目的是调查剖宫产术后产后骨盆X线测量对后续妊娠管理的影响。回顾了331例首次妊娠行剖宫产的妇女的病例记录。根据标准放射学标准，其中248例（75%）的骨盆被认为不适合，83例（25%）的骨盆被认为适合。在放射学检查显示骨盆不适合的妇女中，172例行择期剖宫产。76例允许经阴道分娩：其中51例经阴道分娩，25例需要急诊剖宫产。在放射学检查显示骨盆适合的妇女中，61例经阴道分娩，22例行剖宫产。所有3例子宫破裂病例均发生在放射学检查显示骨盆适合的妇女中。本研究表明，骨盆X线测量不能很好地预测阴道试产的结果。我们得出结论，应摒弃常规产后骨盆测量的做法。
