Abstract
Radiographic pelvimetry is widely used in obstetrics. Every fourth primapara in Sweden is submitted to this radiographic examination. The frequency of the examination in the United States is estimated to a mean of 6% of all deliveries. The use of radiographic pelvimetry is now under intense debate and the missing argument in this discussion is a prospective study of an unselected group of parturients where progress and outcome of labour is referred to known pelvic dimension. Since the value of the method is questioned the frequent use of radiographic pelvimetry is justified only by an almost negligible radiation risk to the mother and her baby. Such a low risk is also an indispensable condition to allow the correct scientific evaluation of radiographic pelvimetry mentioned above. This paper presents the measurement results of absorbed radiation dose with the only radiographic pelvimetry method used in Sweden. The estimated radiation risk of the method, based on these figures, is 1 case of childhood malignancy in 50 000 pelvimetries. This corresponds to 4 years routine use of radiographic pelvimetry in Sweden. The annual incidence of childhood malignancy in Sweden is 220. The maternal risk is estimated to one tenth of the fetal risk.
Highlights
Fetopelvic disproportion increases the hazard of vaginal delivery both for the mother and for the child
This paper presents the measurement results of absorbed radiation dose with the only radiographic pelvimetry method used in Sweden
The monochrome blue and white colour film has the advantage of a wide exposure range, with the effect that bone structures and soft tissues are both well reproduced simultaneously
Summary
Fetopelvic disproportion increases the hazard of vaginal delivery both for the mother and for the child. I t may lead to protracted labour with fetal asphyxia or severe fetal damage due to pathological moulding of the fetal head or shoulder dystocia. The risk of rupture of the maternal vagina and the perineal soft tissue is increased. For identification of women a t risk, manual screening of the pelvic capacity is a widely used method. In women in whom narrow pelvic dimensions are suspected, radiographic pelvimetry is often employed. This latter method has still not been fully evaluated. Manual screening of the pelvic capacity has proved to be an unreliable way of estimating the pelvic dimensions (Lundh et al : to be published)
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