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初产妇X线骨盆测量的价值。II:对分娩管理的影响。

Value of X-ray pelvimetry in primiparas. II: influence on management of labor.

作者信息

Poma P A

出版信息

J Natl Med Assoc. 1982 Mar;74(3):267-72.

Abstract

Despite its potential risks x-ray pelvimetry remains a common diagnostic procedure performed during labor. In order to determine whether x-ray pelvimetry measurements influence the outcome of labor (vaginal vs cesarean), 280 consecutive primiparous parturients were studied.Most parturients were black at term with a vertex presentation. Most pelvimetries were ordered for suspected cephalopelvic disproportion. Of the total number of parturients studied, 31.8 percent had cesarean deliveries, 85.4 percent of them because of CPD. The clinical characteristics compared were similar among the groups studied. X-ray pelvimetry values obtained by two techniques were similar to those previously reported. Although correlations between measurements and delivery route were noted, these values, by themselves, did not have a necessary correlation to the route of delivery in the majority of parturients studied.This finding, like others reported, emphasizes the need to abandon x-ray pelvimetry as a requirement for documenting contracted pelves before abdominal deliveries. CPD should be documented by evaluating the pelvis, quality of labor, and maternal-fetal well-being by other appropriate, less risky means readily available.

摘要

尽管存在潜在风险,但X线骨盆测量仍是分娩期间常用的诊断程序。为了确定X线骨盆测量结果是否会影响分娩结局(顺产与剖宫产),对280例连续的初产妇进行了研究。大多数产妇为足月黑人,胎位为头先露。大多数骨盆测量是因怀疑头盆不称而进行的。在所研究的产妇总数中,31.8%进行了剖宫产,其中85.4%是由于头盆不称。所比较的临床特征在各研究组之间相似。通过两种技术获得的X线骨盆测量值与先前报道的相似。尽管测量值与分娩方式之间存在相关性,但就大多数所研究的产妇而言,这些值本身与分娩方式并无必然关联。与其他报道一样,这一发现强调有必要摒弃将X线骨盆测量作为剖宫产术前诊断骨盆狭窄的必要手段。应通过评估骨盆、产程情况以及母婴健康状况等其他合适且风险较小的现有手段来诊断头盆不称。

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