Problems of the Pelvic Passageway

Thirteen obstetricians from nine countries discuss anatomical and functional aspects of labor in parturients from Europe, Japan, North America and South Africa. With improving socioeconomic conditions, contractions of the pelvic inlet diminish, while those of the outlet remain. To avoid traumatic vaginal deliveries, fetopelvic disproportions must be resolved. In this book, measurements by clinical, X-ray, ultrasound, CT and MRI pelvimetry are presented. Fetopelvic scores for vertex and breech presentations can facilitate delivery planning. Management of labor, dystocia and relative fetopelvic disproportion are outlined, as well as features distinguishing primigravid from multigravid labor. The book also deals with trial of labor, forceps and vacuum extraction, and their effects on fetal and maternal outcome. Many other aspects, such as shoulder dystocia, hypoxia, symphysiotomy, premature rupture of membranes, episiotomies, cervical scores and the use of cervical dilators, are discussed in detail.