The role of radiological pelvimetry in the management of patients who have had a previous caesarean section

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Abstract
A retrospective survey of 239 deliveries of patients who had a previous lower segment caesarean section was carried out. Ninety-one (38 per cent) delivered vaginally and 123 (51 per cent) had an elective caesarean section. Eighty-nine (37 percent) had X-ray pelvimetry performed. An obstetrician''s perception of a contracted pelvis on X-ray resulted in almost universal repeat caesarean section. An adequate pelvis on X-ray was found to be a poor predictor of the outcome of a trial of labour, the state of the cervix at the onset of labour giving much better prediction. The pelvic dimensions of those patients having a successful trial of labour resulting in vaginal delivery were the same as those of patients having an unsuccessful trial of labour resulting in an emergency caesarean section, but the birth weights in the latter group were greater. X-ray pelvimetry is only of limited value in the context of a trial labour following a previous caesarean section; more attention should be paid to the state of the cervix at the onset of labour and to fetal size.

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