Cephalopelvic disproportion (CPD) refers to a relatively common and serious complication of labor and delivery. The baby’s head or shoulders are simply too large to pass through the mother’s pelvis. This can come about when the mother’s pelvis is too small or abnormally shaped, the baby is too large, or some combination of the two factors. If cephalopelvic disproportion is not recognized and dealt with appropriately, the mother and child can both suffer significant birth injuries.
If your child suffered CPD after a difficult delivery, The Becker Law Firm can help. Contact our Ohio CPD attorneys for a free initial consultation.
How is Cephalopelvic Disproportion Identified?
Initially, doctors will have information about the mother’s pelvis type (gynecoid, android, anthropoid, platypelloid) and size by x-ray and examination. Ultrasounds also give the obstetrician a rough idea of the baby’s head measurements.
One other factor is how the baby’s head is positioned in the pelvis—some parts of the baby’s head can mold to conform to the mother’s pelvis. Except for macrosomia (a large baby, usually measuring over 8 lbs., 13 oz.), doctors will not usually assume CPD based on the measurements alone. That is one piece of information that should be considered when deciding whether to abort vaginal delivery in favor of a cesarean section. Another risk factor for CPD is gestational diabetes.
Another indication of cephalopelvic disproportion is failure to progress. Failure to progress means that the labor does not move as quickly as it should.
Risk factors for CPD include:
- Small or abnormal pelvis
- Macrosomia (large baby)
- Large baby head measurements
- Mother with diabetes or gestational diabetes
- Post-term pregnancy
- Mother over age 35
The only correct method of treatment for cephalopelvic disproportion is a cesarean section. Attempts to deliver the baby vaginally will cause undue trauma and possibly permanent injury to the baby.
Effects of Cephalopelvic Disproportion
Cephalopelvic disproportion can cause fetal distress, prolonged labor, brain injury, brachial plexus injuries due to shoulder dystocia, and other birth injuries. When radiologists or ultrasound technicians fail to accurately gauge the baby’s girth, the delivering physician may cause injury by forcing a vaginal birth.
How Medical Negligence Leads to Cephalopelvic Disproportion Injuries
Doctors faced with cephalopelvic disproportion sometimes act negligently.
Here are some common mistakes that obstetricians make:
- Pitocin/Oxytocin: One of the major problems with cephalopelvic disproportion is that doctors can react by administering Pitocin or Oxytocin in an effort to speed up delivery. Too much of these drugs can cause excessive and traumatic contractions, which can injure the baby.
- Continued Labor: Unsure of what to do, many doctors allow labor to progress for far too long. Labor is stressful for babies, and when prolonged, it can cause oxygen-deprivation injuries to the baby. Those injuries can lead to cerebral palsy and developmental delays.
- Shoulder Dystocia: Where cephalopelvic disproportion is a problem, babies are more likely to have shoulder dystocia injuries, including Erb’s Palsy, Klumpke’s palsy, or oxygen problems.
- Prolapsed Umbilical Cord: When there is less room in the uterus, either because of a large baby or a small pelvis, lack of oxygen injuries because of a trapped umbilical cord are more likely.
