[Status of radiologic pelvimetry]

The diagnostic value of radiological pelvimetry is subject to controversial interpretation. This examination is being conducted at the Department of Gynaecology in Aarau (Frauenklinik Aarau) mainly in pregnant women in pelvic presentation or during the puerperium after Caesarean section. Based on 164 radiological pelvimetric measurements in breech presentation and 112 X-ray films after Caesarean section an attempt was made to assess the prospective value of this examination. Abnormal shapes of the pelvis and narrow pelvic dimensions were found about equally often. Analysis of the indications of the section yielded both in breech presentation and in the entire group of the patients examined post partum an almost equally high percentage of about 20% of indications for a disproportionate head-pelvis relationship. Radiologically, considerably narrowed pelvic dimensions were seen in 10% of the examined women. The most frequent finding was a funnel-shaped pelvis, whereas an assimilation pelvis was never seen. Every pathologically narrowed funnel-shaped pelvis and generally narrow pelvis was detected also by digital palpation. All cases of conjugata vera masses below 10 cm concerned generally narrow cases of pelvic dimensions and were thus detectable by digital palpation. We recommended to abstain from routine performance of radiometric pelvimetry. Lateral pelvic X-ray can be an additional help in difficulties in pregnant women with regard to determining the mode of birth in breech presentation and after Caesarean section in case there is an urgent suspicion of malproportionate head-pelvis ratios.