Inlet Contraction of the Pelvis

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Abstract
Summary: 1. A series of 159 patients with contraction of the pelvic inlet has been analysed, and the literature reviewed.2. The over‐all incidence of caesarean section was 53%, and 43% if a trial of labour had been conducted.3. There was no maternal death in the series.4. The foetal mortality (corrected) was 4%. There was no mortality with caesarean section. Earlier resort to caesarean section in some patients would have increased foetal salvage.5. Elective caesarean section is advocated when the obstetrical conjugate is below 9.0 cm.6. The efficiency of uterine action is a major factor in determining the method of delivery. A labour lasting longer than 50 hours is unlikely to terminate in vaginal delivery, and the trial should be discontinued unless delivery seems certain within a few hours.7. Premature rupture of the membranes is a poor prognostic sign; it was associated with a caesarean section rate of 75%.8. A previous vaginal delivery in a patient with a contracted pelvis is not necessarily indicative of a successful vaginal delivery in a subsequent pregnancy. Greater use of caesarean section in such multi‐gravidae who have had a previous difficult delivery seems indicated.9. The incidence of caesarean section in women over 5 feet in height (152 cm.) with a contracted pelvis was increased and was related to the larger size of their babies.10. The incidence of contracted pelvis was greater in Southern European than in Anglo‐Saxon stock, but there was no concomitant increase in the caesarean section rate in such patients.

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