Document Detail


The fetal-pelvic index: a method of identifying fetal-pelvic disproportion in women attempting vaginal birth after previous cesarean delivery.
MedLine Citation:
PMID:  1872337     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In 1986 the fetal-pelvic index was introduced as an accurate method of prospectively identifying the presence or absence of fetal-pelvic disproportion. The concept of the fetal-pelvic index is one in which the fetal head and abdominal circumferences (ultrasonographic mensuration) are compared with the respective maternal pelvic inlet and midpelvic circumferences (x-ray pelvimetry). The purpose of this study is to evaluate the efficacy of this index as a predictor of fetal-pelvic disproportion in gravid women attempting vaginal birth after previous cesarean delivery. Findings of the fetal-pelvic index are compared with those of two other means of identifying fetal-pelvic disproportion (Colcher-Sussman x-ray pelvimetry and ultrasonographically derived estimated fetal weight of greater than or equal to 4000 gm). Of the 65 prospective study participants, 18 (28%) failed to progress in labor, and a repeat cesarean delivery was required. Forty-seven of the 52 patients with a negative fetal-pelvic index value were delivered vaginally (negative predictability = 0.90). Of the five with false-negative fetal-pelvic index values, four fetuses persisted in an occipitoposterior position and failed to progress in labor. All 13 patients with a positive fetal-pelvic index value failed to progress in labor and required a cesarean delivery (positive predictability = 1.00). In contrast, when used alone, neither x-ray pelvimetry nor ultrasonography-determined estimated fetal weight of greater than or equal to 4000 gm provided accurate identification of fetal-pelvic disproportion.
Authors:
G R Thurnau; D H Scates; M A Morgan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  165     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-09-16     Completed Date:  1991-09-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  353-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City 73190.
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MeSH Terms
Descriptor/Qualifier:
Cesarean Section*
Evaluation Studies as Topic
Female
Humans
Pelvimetry / methods*
Predictive Value of Tests
Pregnancy
Prospective Studies
Reoperation
Trial of Labor*
Ultrasonography, Prenatal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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