Cephalopelvic Disproportion in Childbirth

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Table Contents Definition Introduction Symptoms of Cephalopelvic disproportion Causes of Cephalopelvic disproportion Diagnosis of Cephalopelvic disproportion Complications of Cephalopelvic disproportion Treatment of Cephalopelvic disproportion Prevention of Cephalopelvic disproportion Conclusion 2

Definition Cephalopelvic disproportion means that there is a disproportion between the baby s head size and mother s pelvis size. Cephalopelvic disproportion, or CPD, is a relatively rare condition that is diagnosed only during labor. 3

Introduction It can seem like a miracle that a baby can fit through a woman s pelvis during childbirth. Although about 70 percent of all deliveries are vaginal, sometimes the baby s head is too large to pass through the birth canal. A woman s pelvis is designed to expand during pregnancy and delivery. In some cases, the baby s head might be too large to fit through the ischial spines the bones at the narrowest point in a woman s pelvis for normal vaginal delivery. 4

Symptoms of Cephalopelvic disproportion One of the most common signs of cephalopelvic disproportion is prolonged labor or failure of progress. This means that even though there are contractions, the fetus isn t descending and/or the cervix isn t dilating. Unless your doctor identifies that you have cephalopelvic disproportion risk factors, it is unlikely that you would be diagnosed with the condition before you go into labor. 5

Causes of Cephalopelvic disproportion Cephalopelvic disproportion can occur when a woman s anatomy doesn t match the size of her baby s head through the birth canal due to a contracted or abnormally shaped pelvis. This can be caused by genetics or as a result of rickets, pelvic tumors, or a previous injury or accident. Your doctor may try to mitigate some of these risks by inducing labor or changing the position of the fetus, if possible. 6

Causes of Cephalopelvic disproportion Gestational diabetes, which can lead to increased birth size or weight Postmaturity (being pregnant after the anticipated due date, past the third trimester), which can mean that the baby grows larger than normal The position of the fetus Hereditary conditions that can cause the baby to be larger than average 7

Diagnosis of Cephalopelvic disproportion CPD is typically only diagnosed during labor. If labor is ineffective and there has been little or no progress even after medical interventions, the doctor may diagnose CPD. If the doctor diagnoses cephalopelvic disproportion, they ll likely recommend that the baby be delivered by cesarean section. Cesarean sections are the safest method of delivery for both mother and baby in cases of CPD. 8

Complications of Cephalopelvic disproportion The risks or complications associated with CPD are related to the dangers of obstructed labor, prolonged labor, and failure to progress. These can result in: Birth injury Head trauma Shoulder dystocia (when the baby s head passes through, but their shoulders get stuck) Increased risk of stillbirth 9

Complications of Cephalopelvic disproportion For the mother, obstructed labor due to cephalopelvic disproportion could cause serious complications, including: Infections of the uterus, bladder, or vaginal walls Trauma to the bladder or rectum Ruptured uterus, which can cause a hemorrhage, shock, or death 10

Treatment of Cephalopelvic disproportion Trial of Labor Close monitoring of your contractions, dilation, and the baby's progression down the birth canal. Close monitoring of the baby's movements and heart rate. Confirmation of the baby's position with a vaginal exam. Other tests such as X-ray, ultrasound, or MRI to visualize the baby's head and your pelvis. 11

Treatment of Cephalopelvic disproportion Cesarean Section You have had a previous c-section. You are an older first-time mom. The baby is not in a good position for delivery. The baby is overdue by a week or more. You are having complications such as pre- eclampsia. You or the baby are having other medical issues. 12

Prevention of Cephalopelvic disproportion Taking a health history, including your family history, and any surgeries or injuries you may have had. Examining your pelvis for its general size and shape. Using ultrasound results and physical exams to estimate the size of your baby. Monitoring the baby's position inside the womb. 13

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Conclusion As long as women continue to have babies, they will worry about labor and delivery. The good news is that human women have been getting through childbirth safely for over a million years. So, try to remember that labor and delivery is a natural process, and most children are born without any problems. 15

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