Peultier A-S, Cazenave N, Boog G
Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Nantes, quai Moncousu, 44093 Nantes cedex 1, France.
J Gynecol Obstet Biol Reprod (Paris). 2010 Feb;39(1):50-5. doi: 10.1016/j.jgyn.2009.11.002. Epub 2009 Dec 29.
To revalue the interest of X-ray pelvimetry and analyse our current management of patients with a previous caesarean delivery.
Case-control retrospective study reviewing 418 case records of women with a scarred uterus: a study group of 206 parturients who delivered in 2002, when X-ray pelvimetry was the rule, compared with a control group of 212 parturients who delivered in 2007, without any X-ray pelvimetry. Outcomes of labour, influence of X-ray pelvimetry, indications of caesarean sections, rates of uterine rupture and neonatal well-being have been analysed.
There was no significant difference between both groups concerning the outcomes of labour. The transverse pelvic diameter is positively correlated with an eutocic delivery and inversely correlated with the rate of caesarean section performed during labour because of obstructed labour. Measurements of the pelvis were unrelated neither to the risk of uterine rupture nor to the neonatal outcome. The risk of uterine rupture is significantly higher when an emergency caesarean section is required.
Our study brings to light a complementary point of view about X-ray pelvimetry. Indeed, our results show that it could be useful in the following of a caesarean section for obstructed labour.
重新评估X线骨盆测量的意义,并分析我们目前对有剖宫产史患者的处理方式。
病例对照回顾性研究,查阅418例瘢痕子宫女性的病例记录:研究组为206例于2002年分娩的产妇,当时X线骨盆测量是常规检查;对照组为212例于2007年分娩的产妇,未进行任何X线骨盆测量。分析了分娩结局、X线骨盆测量的影响、剖宫产指征、子宫破裂发生率及新生儿健康状况。
两组在分娩结局方面无显著差异。骨盆横径与顺产呈正相关,与因产程梗阻而行剖宫产的发生率呈负相关。骨盆测量与子宫破裂风险及新生儿结局均无关。需要急诊剖宫产时子宫破裂风险显著更高。
我们的研究揭示了关于X线骨盆测量的一个补充观点。确实,我们的结果表明它在因产程梗阻而行剖宫产的过程中可能有用。