[Is there still any interest of x-ray pelvimetry for women with a scarred uterus].

OBJECTIVES: To revalue the interest of X-ray pelvimetry and analyse our current management of patients with a previous caesarean delivery. PATIENTS AND METHODS: Case-control retrospective study reviewing 418 case records of women with a scarred uterus: a study group of 206 parturients who delivered in 2002, when X-ray pelvimetry was the rule, compared with a control group of 212 parturients who delivered in 2007, without any X-ray pelvimetry. Outcomes of labour, influence of X-ray pelvimetry, indications of caesarean sections, rates of uterine rupture and neonatal well-being have been analysed.
RESULTS: There was no significant difference between both groups concerning the outcomes of labour. The transverse pelvic diameter is positively correlated with an eutocic delivery and inversely correlated with the rate of caesarean section performed during labour because of obstructed labour. Measurements of the pelvis were unrelated neither to the risk of uterine rupture nor to the neonatal outcome. The risk of uterine rupture is significantly higher when an emergency caesarean section is required.
CONCLUSION: Our study brings to light a complementary point of view about X-ray pelvimetry. Indeed, our results show that it could be useful in the following of a caesarean section for obstructed labour. Copyright 2009 Elsevier Masson SAS. All rights reserved.