Cephalopelvic disproportion

Question 1

Cephalopelvic disproportion definition

Answer 1

fetus is abnormally large (specifically the head) or the pelvis (specifically the pelvic inlet) is too small or both.

Question 2

Cephalopelvic disproportion
- Features
- Causes

Answer 2

Features

1. In primigravida CPD might be and in following pregnancies it might not be (and vice versa)
2. CPD can be identified before labor (in some cases) or during labor (mostly).

Causes:

• Anatomical variant
• Diabetes mellitus or gestational diabetes ➔ fetal macrosomia
• Pelvic distortion or fracture

Question 3

Cephalopelvic disproportion

Management

Answer 3

Observation and assessment are the key.

2. In primigravid uterus may become exhausted with diminished activity.
3. Head molding – spontaneous resolve by fetal fontanels are flexible and allow movements of the bony plates of the skull.

This aids in the passage through the birth canal.

Following delivery, the baby may have elongated head appearance that usually resolves after few days.

4. Vaginal delivery attempt (continuous monitoring is required)

a. Assessment of uterine activity, cervical dilatation, descent of presenting part and fetal and maternal status.

b. In full cervical dilatation, proper contraction activity – maneuvering and assisted delivery is attempted.

5. C-section

A. Full cervical dilatation with 2-3 contraction every 10 minutes but failure of head descent

b. No cervical dilatation (usually related to poor uterine contraction) for 4-6 hours with no descent of the head

c. Fetal distress