ABSTRACT
The outcome of labour in 177 Nigerian primigravidae in whom clinical pelvic assessment was performed before delivery, is studied. No significant difference occurred in the mode of delivery for the rank of the pelvic assessors (consultants or resident doctors) at x = 0.05. No significant difference also occurred in the incidence of caesarean section between the pelvic assessed and the unassessed patients, and between those whose pelves were assessed adequate and those assessed inadequate. One-minute Apgar scores were significantly higher for fetuses delivered of women with adequate pelves compared to those with (i) borderline pelves (Z = 3.46, p < 0.001), (ii) unassessed pelves (Z = 2.84, p < 0.005) and (iii) the not adequate pelves-borderline and inadequate (Z = 3.04, p < 0.005), thereby conferring a predictive role on Apgar scores to clinical pelvimetry. The procedure is cost-free and requires minimal guidance to perfect. Its continued practice in routine ante-natal care in developing countries is therefore advocated.
PIP: Clinical pelvimetry has been used in obstetrics practice in developing countries to prevent cephalopelvic disproportion. Questions have been raised, however, about the accuracy of this technique. This issue was addressed in a retrospective study of all 177 primigravidae who delivered at Nigeria's Nnamdi Azikiwe University Teaching Hospital in 1990-93. Of the 132 of these women who underwent pelvic assessment, the pelvis was deemed adequate in 119 (90.16%), borderline in 10, and inadequate in 3. Pelvic assessment performance or findings were not significantly associated with the assessor (consultant or resident doctor) or cesarean delivery rate; however, 1-minute Apgar scores were significantly higher among infants of mothers assessed to have an adequate pelvis than those with a borderline pelvis (p 0.001), an inadequate pelvis (p 0.005), or not assessed (p 0.005). It is recommended that developing countries without sophisticated monitoring equipment continue the practice of clinical pelvimetry and perform radiological pelvimetry in women with a borderline or inadequate pelvis.