Breech delivery: the value of X-ray pelvimetry

Abstract

Objective: The study was conducted to compare maternal and neonatal outcome of two groups of nulliparae with breech presentations, who were selected for vaginal delivery by protocols differing only in their use of X-ray pelvimetry.

Study design: We reviewed all term singleton breech deliveries of nulliparous patients who were eligible for vaginal trial of labour in our Centre between 1992 and 1994. In Group A (n=85) X-ray pelvimetry was performed, and in Group B (n=70) it was not. Obstetric management was otherwise similar. Admission to the two departments was on alternate days.

Results: The rate of caesarean section was similar in both groups (Group A, 36.4% vs. Group B, 42.8%; P>0.05), however, the indications for caesarean section differed. Neonatal outcome was similar in both groups. Maternal febrile morbidity was higher in Group B patients, especially those who underwent caesarean section after a trial of labour.

Conclusion: X-ray pelvimetry in nulliparae with breech presentation is associated with reduced maternal febrile morbidity, but does not improve neonatal outcome.