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Related Experiment Videos

Term breech delivery: does X-ray pelvimetry help?

A Biswas1, M J Johnstone

  • 1Department of Obstetrics and Gynaecology, Fazakerley Hospital, Liverpool, United Kingdom.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|May 1, 1993
PubMed
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Routine X-ray pelvimetry is not necessary for term breech presentations. Avoiding this imaging reduced Cesarean sections without negatively impacting neonatal outcomes, suggesting labor progress is a better indicator.

Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Medicine
  • Diagnostic Imaging

Background:

  • Breech presentation at term requires careful consideration for delivery mode.
  • X-ray pelvimetry has been historically used to assess pelvic adequacy for vaginal birth.
  • The necessity of X-ray pelvimetry in uncomplicated term breech presentations is debated.

Purpose of the Study:

  • To evaluate the role of X-ray pelvimetry in the management of term singleton breech presentations.
  • To compare obstetric and neonatal outcomes based on the use of X-ray pelvimetry for delivery mode decisions.

Main Methods:

  • Retrospective audit of 267 term singleton breech presentations over 3 years.
  • Comparison of outcomes across three groups based on X-ray pelvimetry usage: none, always, selective.

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  • Outcomes assessed included mode of delivery, Apgar scores, birth trauma, and neonatal special care unit admission.

    • Main Results:

    • Significantly fewer elective Cesarean sections in the group not using X-ray pelvimetry (12.9%) compared to groups using it (27.2% and 33.8%; p < 0.05).
    • Vaginal delivery rates after a trial of labor were similar across all groups (79.1%, 65.9%, 65.1%).
    • Neonatal outcomes, including Apgar scores and birth trauma, were comparable among the groups.

    Conclusions:

    • X-ray pelvimetry is not essential for determining the mode of delivery in uncomplicated term singleton breech presentations.
    • Avoiding routine X-ray pelvimetry can lead to a reduction in Cesarean sections without compromising neonatal safety.
    • Satisfactory progress in labor is a more reliable indicator of pelvic adequacy for vaginal breech delivery.