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A retrospective review of performance and utility of routine clinical pelvimetry.

Publication ,  Conference
Blackadar, CS; Viera, AJ
Published in: Fam Med
2004

BACKGROUND AND OBJECTIVES: Some authorities have questioned the utility of performing clinical pelvimetry as part of routine prenatal care. This study determined the frequency with which clinical pelvimetry is still performed at two military hospitals and whether the results of pelvimetry influence the management of labor and delivery. METHODS: We conducted a retrospective review of prenatal records at two military hospitals. One was an overseas hospital, and one was a family medicine teaching hospital in the United States. The records of 660 pregnant women were reviewed to identify documentation that pelvimetry was performed during prenatal care and whether there was evidence that the physician managing labor and delivery altered management based on pelvimetry results. RESULTS: Seventy percent (461) of the 660 records reviewed had all pelvimetry measurements documented as normal, or the provider had written "good for TOL (trial of labor)," "proven to XX pounds," or similar annotation that pelvimetry was normal. Nine percent (58 records) had no documentation of pelvimetry (pelvimetry section left blank). The remaining 21% (141 charts) had at least one pelvimetry measurement listed as abnormal on the initial prenatal exam. No admission note, progress note, or operative note recorded during labor and delivery made reference to clinical pelvimetry results. No abnormal pelvimetry result was referenced in follow-up visits or appeared to make any difference in mode of delivery or treatment in labor. Two women (one at each institution) had initial visit notes indicating the need to consider radiographic pelvimetry based on the results of clinical exam, but this test was not done in either case, and both women delivered vaginally. CONCLUSIONS: Our study indicates that clinical pelvimetry does not change management of pregnant patients. Current practice is to allow all women a trial of labor regardless of pelvimetry results. This makes the routine performance and recording of clinical pelvimetry a waste of time, a potential liability, and an unnecessary discomfort for patients.

Duke Scholars

Published In

Fam Med

ISSN

0742-3225

Publication Date

2004

Volume

36

Issue

7

Start / End Page

505 / 507

Location

United States

Related Subject Headings

  • Trial of Labor
  • Retrospective Studies
  • Prenatal Care
  • Pregnancy
  • Pelvimetry
  • Humans
  • Hospitals, Military
  • General & Internal Medicine
  • Female
  • 13 Education
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Blackadar, C. S., & Viera, A. J. (2004). A retrospective review of performance and utility of routine clinical pelvimetry. In Fam Med (Vol. 36, pp. 505–507). United States.
Blackadar, Charles S., and Anthony J. Viera. “A retrospective review of performance and utility of routine clinical pelvimetry.” In Fam Med, 36:505–7, 2004.
Blackadar CS, Viera AJ. A retrospective review of performance and utility of routine clinical pelvimetry. In: Fam Med. 2004. p. 505–7.
Blackadar, Charles S., and Anthony J. Viera. “A retrospective review of performance and utility of routine clinical pelvimetry.Fam Med, vol. 36, no. 7, 2004, pp. 505–07.

Published In

Fam Med

ISSN

0742-3225

Publication Date

2004

Volume

36

Issue

7

Start / End Page

505 / 507

Location

United States

Related Subject Headings

  • Trial of Labor
  • Retrospective Studies
  • Prenatal Care
  • Pregnancy
  • Pelvimetry
  • Humans
  • Hospitals, Military
  • General & Internal Medicine
  • Female
  • 13 Education