Pelvimetry for fetal cephalic presentations at or near term

 

Abstract

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 methods

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.

 

Plain language summary

Pelvimetry for fetal cephalic presentations at or near term

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.

 

摘要

背景

在生產期或接近產期時對於胎兒頭產式的骨盤測量法(pelvimetry)

骨盤測量法的目地是透過評估婦女的骨盆尺寸來預測她將能夠進行生產與否。這種測量法的執行方法有臨床(理學)檢查，或是藉由傳統的X光、電腦斷層掃描，或是核磁共振攝影

目標

本篇回顧的目的，是要就生產方法、周產期胎兒的死亡率與罹病率，以及母體的死亡率來評估骨盤測量法(pelvimetry)的效用(在生產前、生產中或是生產後實施)

搜尋策略

我們搜尋了the Cochrane Pregnancy and Childbirth Group's Trials Register(2007年六月27日)

選擇標準

關於在各種頭產式(cephalic presentations)中對於骨盤測量法的使用，可接受的隨機比較

資料收集與分析

有1位作者評估了試驗的品質並擷取出資料

主要結論

其中包含了4組試驗與超過1000名婦女。所有的試驗都是用X光的骨盤測量法來評估骨盆。這些試驗的品質通常都不佳。接受X光骨盤測量法的婦女都比較傾向於藉由剖腹的方式來進行生產(odds ratio 2.17, 95% confidence interval 1.63 to 2.88)。在周產兒的狀況方面，並沒有偵測到明顯的影響

作者結論

對於那些來自頭產式之胎兒，在將他們生下來的婦女身上，並沒有足夠的證據可支持使用X光骨盤測量法

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

證據太少而不足以證實當嬰兒已經處於頭位時測量婦女的骨盆尺寸(骨盤測量法)是否有利。有時候，任何一名懷孕的婦女或是負責照護她的人，可能會擔心骨盆骨可能太小，而無法在生產的期間讓嬰兒通過。骨盤測量法是用X光、電腦斷層掃瞄，或是核磁共振攝影來測量骨盆的尺寸。針對肚中的孩子處於頭部朝下(頭產)位置的婦女，本篇試驗回顧發現，證據太少而不足以證實骨盤測量法是否有利。有一些證據顯示，接受骨盤測量法的婦女比較容易於剖腹產，但是並沒有任何試驗可以證實這麼做是否會對嬰兒有利