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Summary: 1. A series of 159 patients with contraction of the pelvic inlet has been analysed, and the literature reviewed. 2. The over-all incidence of caesarean section was 53%, and 43% if a trial of labour had been conducted. 3. There was no maternal death in the series. 4. The foetal mortality (corrected) was 4%. There was no mortality with caesarean section. Earlier resort to caesarean section in some patients would have increased foetal salvage. 5. Elective caesarean section is advocated when the obstetrical conjugate is below 9.0 cm. 6. The efficiency of uterine action is a major factor in determining the method of delivery. A labour lasting longer than 50 hours is unlikely to terminate in vaginal delivery, and the trial should be discontinued unless delivery seems certain within a few hours. 7. Premature rupture of the membranes is a poor prognostic sign; it was associated with a caesarean section rate of 75%. 8. A previous vaginal delivery in a patient with a contracted pelvis is not necessarily indicative of a successful vaginal delivery in a subsequent pregnancy. Greater use of caesarean section in such multi-gravidae who have had a previous difficult delivery seems indicated. 9. The incidence of caesarean section in women over 5 feet in height (152 cm.) with a contracted pelvis was increased and was related to the larger size of their babies. 10. The incidence of contracted pelvis was greater in Southern European than in Anglo-Saxon stock, but there was no concomitant increase in the caesarean section rate in such patients.

To evaluate the safety and integrity of uterine scar at repeat cesarean section in patients with previous one cesarean section (C/S). A prospective study was Carried out in a tertiary care, obstetric unit over a period of one year, 2010. All pregnant mothers who underwent cesarean section either emergency or elective with history of previous one cesarean sections were included in this study. The variables noted were age, parity, socioeconomic status, residential area, location of previous cesarean section, previous wound infection and associated complaints. Data was analyzed on SPSS 11 Operative findings during cesarean sections were recorded in terms of thinning of scar, dehiscence or rupture. One hundred and twenty cesarean section patients were included in the study. Out of all patients, extreme thinning of scar was noted in 28 (23.33%) patients. Four patients (3.33%) had scar dehiscence,only 3( 2.5%) patients with scar dehiscence had associated complaint of scar tenderness, while 17 (14.16%) of 120 cases of scar thinning were having scar tenderness. All 4 cases of scar dehiscence had their previous c/s at peripheral hospitals. No patient underwent hysterectomy and all patients with scar dehiscence had successful repair. Our findings shows relatively inadequate scar thickness rate but at the same time relatively acceptable scar dehiscence rate. Thus it seems to be a safe approach to make trial of labour after meticulous scrutinization and individualization. DOI: http://dx.doi.org/10.3329/akmmcj.v3i1.10108 AKMMCJ 2012; 3(1): 16-19

All cases referred for pelvimetry in 1970-1 and all breech presentations referred for pelvimetry in 1972-4 were reviewed. Indications for pelvimetry fell into four main categories: high head in the antenatal clinic (47-8%); high head in labour (13-9%); breech presentation (20-9%); and previous caesarean section (14-8%). In the first two categories pelvimetry rarely if ever influenced management, and it should not be performed routinely. In breech presentation and cases of caesarean section pelvimetry seemed to be of value, but in the latter group it should be performed puerperally to avoid the known radiation hazard to the fetus. A fairly close correlation between obstetric conjugate and pelvic capacity was shown, which suggested that a 3400-g baby might pass through a pelvis of obstetric conjugate of 10 cm as a cephalic trial of labour, but would need an obstetric conjugate of 11-7 cm for safe vaginal breech delivery.