RESUMO
Among 201 primigravidae, pelvic assessment was analyzed prospectively during the third trimester to detect patients likely to suffer from cephalo-pelvic disproportion (CPD). If the sacral promontory (SP) was reached by the index finger (9.0-9.5 cm true conjugate) the pelvis was regarded as "suspect". All patients who later developed CPD were in this group. Of the screened primigravidas, 22% were advised to deliver in the hospital. Pelvic assessment is an important screening tool during antenatal care to detect high-risk primigravidas.
PIP: Among 201 primigravida, pelvic assessment was analyzed prospectively during the 3rd trimester to detect patients likely to suffer from cephalo-pelvic disproportion (CPD). Patients were attending the Kondoa Hospital in Central Tanzania for prenatal assessment. Patients were divided into 3 groups: 1) Sacral promontory not reached; 2) Sacral promontory just reached; and 3) Sacral promontory easily reached. If the sacral promontory was reached by the index finger (9.0-9.5 cm true conjugate) the pelvis was regarded as 'suspect.' All patients who later developed CPD were in this group. Of the screened primigravidas, 22% were advised to deliver in the hospital. Compared to other simple methods, pelvic assessment required more skill and some equipment, but performed properly, it may affect patient compliance positively by removing fear of hospital admission in case of emergency. We believe that pelvic assessment is a simple method, associated with a high sensitivity and a very high specificity, to detect patients at risk for CPD. In a series only measuring maternal height, a full 15% of actual CPD cases were not detected by Aitken and Walls.
