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The Value of Pelvioradiography in the Management of Dystocia

1943; Elsevier BV; Volume: 46; Issue: 2 Linguagem: Inglês

10.1016/s0002-9378(15)32916-1

1097-6868

Arthur G. Weinberg, Samuel J. Scadron,

Pregnancy and preeclampsia studies

A series of 280 obstetric cases in which dystocia was expected were studied by pelvioradiography as an aid in determining the obstetrical prognosis and treatment. The cases were classified in four groups: no disproportion, borderline, relative, and absolute disproportion; and the prognosis was good, fair, guarded and poor, respectively. Treatment recommended was based on the above considerations. 1.The roentgen prognosis was correct in 97.9 per cent. 2.As the prognosis became worse the incidence of operative deliveries increased. 3.Cesarean section was necessary for good results when poor prognosis was given by x-ray pelvimetry. 4.In 52 cases in which cesarean was considered likely, it was performed in 41 and should have been performed in 7 more as indicated by disastrous results following vaginal delivery. 5.The conservative influence of pelvioradiography in a dystocia series was shown by the fact that only 114 or 40 per cent required operative delivery. 6.The android and platypelloid pelves were frequently found among the cases in which poor prognosis was given. 7.he anthropoid pelves were all given a favorable prognosis, and subsequent events proved this confidence justified. 8.The gynecoid pelvis was the most difficult to evaluate correctly and the size of the pelvis was often the chief guide. There was an increase in operative deliveries in the following order: anthropoid, gynecoid, platypelloid and android. 9.Half of the stillbirths could have been avoided if the radiologic advice had been followed. 10.The cesarean operation was more accurately limited to those cases in which it was essential.