What is Cephalopelvic Disproportion (CPD)?
Cephalopelvic Disproportion (CPD) is a condition where the baby's head or body is too large to fit through the mother's pelvis during childbirth. This can be due to either the size of the fetus or the small size of the maternal pelvis. CPD can result in
complications during labor and delivery, often necessitating medical intervention.
Causes of CPD
There are several factors that can contribute to CPD: Macrosomia: This is a condition where the baby is significantly larger than average, often due to maternal conditions like
gestational diabetes.
Pelvic Abnormalities: A small or abnormally shaped pelvis can make vaginal delivery difficult or impossible.
Fetal Position: Abnormal fetal positions, such as breech or transverse lie, can contribute to CPD.
Maternal Conditions: Conditions such as
rickets or previous pelvic fractures can affect the size and shape of the pelvis.
Diagnosis of CPD
CPD is often diagnosed during labor when it becomes apparent that the baby cannot pass through the birth canal. However, certain factors can raise suspicion of CPD before labor begins: Ultrasound Measurements: Ultrasound can estimate the baby's size and the dimensions of the maternal pelvis.
Clinical Pelvimetry: This is a manual examination to assess the size and shape of the pelvis.
Medical History: A history of difficult deliveries or previous CPD can be indicative.
Treatment Options
When CPD is diagnosed, various treatment options are considered: Cesarean Section (C-section): This is the most common treatment for CPD and involves surgical delivery of the baby.
Trial of Labor: In some cases, especially where CPD is not certain, a trial of labor may be attempted under close medical supervision.
Forceps or Vacuum Extraction: These methods may be used in certain situations, though they carry risks and are less common.
Risks and Complications
Untreated or improperly managed CPD can lead to several complications: Prolonged Labor: This can increase the risk of maternal and fetal distress.
Birth Injuries: Both the mother and baby are at higher risk for injuries during delivery.
Postpartum Hemorrhage: Excessive bleeding after delivery can occur.
Infections: Both surgical and vaginal deliveries carry a risk of infection, which can be exacerbated by CPD.
Prevention and Management
While CPD cannot always be prevented, certain measures can help manage the risk: Prenatal Care: Regular prenatal visits can help monitor the baby's size and position, as well as the health of the mother.
Management of Maternal Conditions: Proper management of conditions like gestational diabetes can reduce the risk of macrosomia.
Birth Planning: Discussing potential delivery options with a healthcare provider can prepare the mother for the possibility of CPD.
