X-ray pelvimetry: prognosis of delivery by cephalous-pelvic confrontation in Cotonou

Abstract

Background: The mechanical dystocia constitutes one of the causes of maternal death during labour. Reducing the incidence of complications of dystocia means recognize the factors induce dystocia. That justifies X-ray pelvimetry and cephalic fetal ultrasonography to predict the outcome of labour. This survey aims at establishing the prognosis of labour by a cephalous-pelvic confrontation.Methods: This study was realised at CUGO and HOMEL, reference maternity hospitals in Cotonou from 28th March to 4th August 2006. That was a prospective study. During prenatal visit, pregnant women who had pelvis abnormality were recruited after their consent after counselling about exploration of their pelvis and fetal cephalic diameters. Pregnant women in their ninth month underwent to X-ray pelvimetry and fetal biometric ultrasonography.Results: During that study, 122 pregnant women in their ninth month were recruited. Favourable prognosis (36.89%): natural delivery 31.15%; (concordance rate is 84.44%). Uncertain prognosis (18.85%): caesarean section (10.66%), natural delivery (7.37%). Unfavourable prognosis (44.26%): 40.16% deliveries by caesarean section. Concordance rate is 90.74%.Conclusions: The cephalous-pelvic confrontation is a reliable prognosis method. It is recommendable in our maternity hospitals to prevent complications of dystocia, a cause of maternal death.