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Breech delivery: the value of X-ray pelvimetry
G Fait1, Y Daniel, J B Lessing
1Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Israel.
Summary
X-ray pelvimetry for nulliparous women with breech presentation did not alter neonatal outcomes but reduced maternal febrile morbidity. This study compares outcomes with and without X-ray pelvimetry in breech deliveries.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Radiology in Obstetrics
Background:
- Breech presentation in nulliparous women poses delivery challenges.
- Vaginal delivery protocols for breech presentations vary regarding imaging use.
- X-ray pelvimetry is a tool to assess pelvic dimensions for delivery planning.
Purpose of the Study:
- To compare maternal and neonatal outcomes in nulliparous women with breech presentation undergoing vaginal delivery.
- To evaluate the impact of X-ray pelvimetry on delivery outcomes.
- To assess if X-ray pelvimetry influences caesarean section rates and maternal/neonatal complications.
Main Methods:
- Retrospective review of term singleton breech deliveries in nulliparous patients (1992-1994).
- Two groups were compared: Group A (n=85) with X-ray pelvimetry and Group B (n=70) without.
- Standardized obstetric management and alternate-day admission to departments ensured comparability.
Main Results:
- Caesarean section rates were similar between groups (36.4% vs. 42.8%, P>0.05).
- Neonatal outcomes were comparable across both groups.
- Maternal febrile morbidity was higher in the group without X-ray pelvimetry, particularly after a trial of labour.
Conclusions:
- X-ray pelvimetry in nulliparous women with breech presentation is linked to decreased maternal febrile morbidity.
- The use of X-ray pelvimetry did not demonstrate an improvement in neonatal outcomes.
- X-ray pelvimetry may be beneficial for reducing maternal complications in selected breech deliveries.