Pelvimetry for fetal cephalic presentations at or near term

Pattinson RC, Farrell E-ME

Published Online:

January 21, 2009

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.

Abstract (click to read)

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 strategy:

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.

This record should be cited as:

Pattinson RC, Farrell E-ME. Pelvimetry for fetal cephalic presentations at or near term. Cochrane Database of Systematic Reviews 1997, Issue 2. Art. No.: CD000161. DOI: 10.1002/14651858.CD000161

Assessed as up to date:

June 27, 2007

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Primary Review Group:

Pregnancy and Childbirth Group

Health topics:

Pregnancy & childbirth > Dystocia > Fetopelvic disproportion

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Pelvimetry for fetal cephalic presentations at or near term

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