The Radiological Diagnosis of Disproportion

Abstract

It should be dogmatically stated at the beginning of this paper that a radiological examination for disproportion should always be regarded as an ancillary or secondary method to supplement a thorough clinical examination. Radiological examination can be of considerable value in selected cases, and the selection should be made by the most experienced obstetrician available in clinic, hospital, or private practice. A consultant clinical opinion should not be short-circuited by X-ray examination. That there is real justification for radiological investigation of disproportion may be supported by two short quotations from recent writings of well-known obstetricians. Fitzgibbons1 writes:—“At the present time the number of women treated by induction of labour and Cæsarean section is greater than the number of women who suffered from dystocia before the perfection and adaptation of these methods of treatment, but the number of craniotomies, difficult deliveries and the disastrous results of deliveries with forceps is not diminished. It suggests that the application of operative interference for the purpose of avoiding dystocia is not wholly confined to cases calling for such treatment, while it is undoubtedly not applied to many cases in which it would benefit.” My second quotation is from a recent writing by Leslie Williams2:—“The estimation of possible disproportion between the head and pelvis is one of the most difficult things in obstetrics … the more experienced the degree of difficulty to be anticipated.