Thubisi M, Ebrahim A, Moodley J, Shweni P M
Department of Obstetrics and Gynaecology, Faculty of Medicine, Congella, South Africa.
Br J Obstet Gynaecol. 1993 May;100(5):421-4. doi: 10.1111/j.1471-0528.1993.tb15265.x.
To determine whether antepartum X-ray pelvimetry (XRP) reliably identified women suitable for a trial labour or repeat elective caesarean section after one previous section.
A prospective controlled trial in which women were randomly allocated to either an antepartum XRP group who had XRP at 36 weeks gestation to determine mode of delivery, or a control group who had a trial labour without antepartum XRP. Following delivery, all controls had postpartum XRP.
Department of Obstetrics and Gynaecology, King Edward VIII Hospital, Durban, South Africa.
Three hundred-six women with a history of one previous caesarean section.
Mode of delivery, birthweight and maternal and perinatal mortality and morbidity in the two groups.
In the antepartum XRP group, 23 of 144 (16%) of women delivered vaginally compared with 60 of 144 (42%) controls (P < 0.0001). Of the 84 women with adequate antepartum XRP only 23 (27.7%) delivered vaginally. In the control group, 33 of 60 (55%) women who had vaginal deliveries had inadequate postpartum XRP and would have had a caesarean section if this information was known in the antepartum period; 62 of 84 (74%) caesarean sections in the control group had adequate postpartum XRP. Birthweight of the infants was similar in the two groups. There were no maternal or perinatal deaths. Maternal morbidity was similar in the two groups. Neonatal morbidity was minimal.
Antepartum XRP is not necessary prior to a trial labour in women with one previous caesarean section. It increases the caesarean section rate and is a poor predictor of the outcome of labour.
确定产前X线骨盆测量（XRP）能否可靠地识别适合进行试产或在有过一次剖宫产史后再次择期剖宫产的女性。
一项前瞻性对照试验，将女性随机分为产前XRP组（在妊娠36周时进行XRP以确定分娩方式）或对照组（进行试产但未进行产前XRP）。分娩后，所有对照组产妇均进行产后XRP检查。
南非德班爱德华八世国王医院妇产科。
306名有过一次剖宫产史的女性。
两组的分娩方式、出生体重以及孕产妇和围产期死亡率及发病率。
产前XRP组中，144名女性中有23名（16%）经阴道分娩，而对照组144名女性中有60名（42%）经阴道分娩（P<0.0001）。在84名产前XRP检查结果合适的女性中，只有23名（27.7%）经阴道分娩。在对照组中，60名经阴道分娩的女性中有33名（55%）产后XRP检查结果不合适，如果在产前就知道该信息，她们将会接受剖宫产；对照组84例剖宫产中有62例（74%）产后XRP检查结果合适。两组婴儿的出生体重相似。没有孕产妇或围产期死亡。两组的孕产妇发病率相似。新生儿发病率极低。
对于有过一次剖宫产史的女性，试产前不需要进行产前XRP检查。它会增加剖宫产率，且对分娩结局的预测能力较差。
