Antenatal clinical pelvimetry and labour outcome in primigravidea

Abstract

Aim: To analyse the resesults of clinical pelvimetry in relation to labour outcome so as to determine the ability of clinical pelvimetry to predict insurmountable disproportion. Patients and Methods: A retrospective analysis of the results of clinical pelvimetry in relation to labour outcome in 209 primigravidea at the University of Nigeria Teaching Hospital, Enugu, Nigeria was undertaken. A positive test was defined as any case with borderline or contracted pelvis. Results: A significantly greater proportipn of those with a positive result underwent caesarean section than those with a negative result. Despite this, the sensitivity of clinical pelvimetry in identifying women with insurmountable disproportion was 34.1% with a specificity of 83.2%, a positive predictive value of 41.7% and a negative predictive value of 83.2%. The relative risk of undergoing caesarean section by those with borderline or contracted pelves was 3.36 times that of those with clinically normal pelves. Conclusion: In areas such as the developing countries where quick intervention is not normally feasible because of logistic reasons, clinical pelvimetry may forewarn of an increased risk of caesarean delivery so that early measures can be commenced to shorten the decision-intervention interval.

Keywords

• clinical pelvimetry
• prediction
• delivery route