ABSTRACT
To evaluate the role of antenatal CT pelvimetry in choosing the appropriate delivery method for patients with prior caesarean delivery in view of the obstetric and perinatal outcome. A prospective study of the outcome of trial labour among pregnant women with prior caesarean section between October, 1992 and December 1993. All women had singleton term vertex pregnancy, accepting trial labour and with no contraindications for trial labour. Eighty two patients had fulfilled the study criteria and were allocated to either inadequate pelvis group [48 cases] or to adequate pelvis group [34 cases] according to data obtained by antenatal CT pelvimetry. Seventy two percent [59/82] of the study patients had successful vaginal deliveries. Seventy one percent [34/48] of inadequate pelvis group delivered vaginally and twenty nine percent [14/48] required a caesarean delivery after a trial of labour. With adequate pelvis, vaginal delivery was 74% [25/34] and caesarean delivery was 26% [9/34] after trial labour. No significant difference between study groups as regard occurrence of vaginal delivery after prior caesarean birth. Significant, higher incidence of intrumental vaginal deliveries, I perineal trauma, blood loss, longer hospital stay and neonatal jaundice were reported among cases with inadequate peivis. Perinatal outcome including Apgar scores, cord gases and neonatal complications was comparable in both study groups. Pregnant women after prior one caesarean delivery should be allowed to trial labour regardless of pelvimetric results in absence of other obstetric indications for C.S. Antenatal pelvimetry is helpful in identification of women who are more liable for operative vaginal delivery and should be monitored more closely in labour