Abstract
In modern obstetric practice the aim of the
accoucheur is to obtain a vaginal delivery where
possible, but only if this object can be reached
without injury to mother or child. Because of
this attempt to obtain delivery per vias naturalis
the maternal pelvis has been the subject of close
study by obstetricians for many years. Attempts
to measure the pelvis in the living subject has
resulted in many varieties of pelvimeter and
manual methods of measurement, but it was not
until the improvement in X -ray technique that an
accurate study of the pelvic architecture was
Possible and reliable measurements made.
A large bibliography has accumulated on the
study of radiological technique in the pregnant
woman, both in this country, Europe and America,
and some of these papers will be referred to later.
On studying the published series, especially from
Britain, it was apparent that there was a consider
able variation in the results, and it seemed to me
that it would be worth studying the problem in
this area, i.e. the South -East of Scotland. I
considered that by obtaining a fairly large series
of cases and correlating this with various findings
such as maternal height, baby weight and duration
of labour, one would have a basis on which to
assess future cases in our own hospital.
Another valuable contribution that X -ray
pelvimetry makes possible to us in this region in
which all the maternity hospitals are congregated
in a small area, is to be able to assess a case
that may be delivered elsewhere. Many cases are
delivered in Cottage hospitals or at home, often at
a distance of 50 miles from the main centres, and
one is frequently sent cases by their general
practitioner with a request to ascertain whether
labour will be normal or not. While I do not
underestimate the value of abdominal and vaginal
examination with an estimate of cephalo- pelvic
disproportion, the fact remains that in many women
there is pelvic contraction at a lower level than
the brim of the pelvis, and this may be difficult
to assess antenatally in some patients. Nowadays
many general practitioners are unwilling to under - take any operative delivery themselves, even a low
forceps, and they expect an obstetric opinion to
eliminate these when possible. 'Even in a good
home a forceps delivery is often undesirable,and
this point was brought out by Aitken (1955) speaking on behalf of the general practitioners of
South Lincolnshire at the British Congress of
Obstetrics at Oxford.
