*5.2.6 Caesarean section indications and external pelvic diameters in Rwanda*

A cross-sectional and analytical study was made on data collected from 32 operated parturients among 152 nulliparae who gave birth with singleton pregnancy at term and vertex presentation within the three first months of the abovementioned prospective longitudinal survey in the Southern Province of Rwanda [61]. Anthropometric measurements (external pelvic diameters in cm) were collected at first antenatal care consultation. At childbirth, midwives and physicians monitored labour in a blind way and the following data were collected after delivery by the investigators: way of delivery (per vaginam or caesarean section), and caesarean section indication. Student's *t* test was used to compare mean values from a normally distributed population (Kolmogorov-Smirnov test). This study showed a relationship between external pelvic sizes and caesarean section indications related to obstructed labour due to pelvic dystocia. Clinically diagnosed pelvis contraction was characterised by smaller average measurements in comparison with other caesarean section indications. Apart from biiliac (intercrestal) diameter, observed differences were statistically significant for all other external pelvic diameters, i.e. antero-superior iliac interspinous, intertrochanter, Baudelocque's, and intertuberous (**Table 8**) [55].


#### **Table 8.**

*External pelvimetry and caesarean section indication in Rwandan nulliparae.*
