Pelvimetry for fetal cephalic presentations at or near term
Abstract
Background
Pelvimetry assesses the size of a woman's pelvis aiming to predict whether she will be able to deliver or not. This can be done by clinical examination, or by conventional x‐rays, computerised tomography scanning, or magnetic resonance imaging.
Objectives
The objective of this review was to assess the effects of pelvimetry (performed antenatally, intrapartum or postpartum) on the method of delivery, and on perinatal mortality and morbidity, and on maternal morbidity.
Search methods
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (27 June 2007).
Selection criteria
Acceptably randomised comparisons of the use of pelvimetry in cephalic presentations.
Data collection and analysis
One author assessed trial quality and extracted the data.
Main results
Four trials of over 1000 women were included. All used x‐ray pelvimetry to assess the pelvis. The trials were generally not of good quality. Women undergoing x‐ray pelvimetry were more likely to be delivered by caesarean section (odds ratio 2.17, 95% confidence interval 1.63 to 2.88). No significant impact was detected on perinatal outcome.
Authors' conclusions
There is not enough evidence to support the use of x‐ray pelvimetry in women whose fetuses have a cephalic presentation.
PICOs
Plain language summary
Pelvimetry for fetal cephalic presentations at or near term
Too little evidence to show whether measuring the size of the woman's pelvis (pelvimetry) is beneficial when the baby is in a cephalic position.
Sometimes, a pregnant woman or her caregiver might be worried that the pelvic bones might be too small for the baby to pass through during birth. Pelvimetry measures pelvic size using x‐ray, computerised tomography scanning or magnetic resonance imaging. For women whose baby is in a head down (cephalic) position, the review of trials found too little evidence to show whether pelvimetry is beneficial. There is some evidence that women having pelvimetry are more likely have a caesarean section, but there are no trials that show whether this is beneficial for the baby.
