VAGINAL DELIVERY AFTER ONE PREVIOUS CAESAREAN SECTION: IS RADIOLOGICAL PELVIMETRY NECESSARY?

ABSTRACT

Objective: To examine whether antepartum x-ray pelvimetry reliably predicts the likelihood of vaginal birth after one previous caesarean section (VBAC).

Design: Retrospective study.

Setting: Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital (LUTH), Nigeria.

Population: Patients with one previous caesarean delivery without prior vaginal delivery who had x-ray pelvimetry done at term.

Methods: Medical records of 207 patients with previous vaginal delivery who delivered between January 1999 and December 2001 were reviewed.

Outcome Measures: Mode of delivery.

Results: 143 (69%) had radiologic pelvimetry done, out of which 114 (80%) had radiologically adequate pelvis. Of these, 90 (79%) were allowed a trial of labour. Forty women (44.4%) patients who were allowed a trial of labour delivered vaginally while 50 (55.6%) had emergency repeat caesarean section for various indications.

Conclusion: Antepartum radio-pelvimetry is a poor predictor of the outcome of labour.