It’s amazing how a mother’s body makes room for a growing fetus. But leaving her body can be a challenge, especially in the case of a CPD birth (Cephalopelvic Disproportion birth). We’ll tell you all about this birth complication below.
What is Cephalopelvic Disproportion (CPD)?
Cephalopelvic Disproportion is the medical term for a mismatch between the size of a baby’s head (cephalus) and the mother’s pelvis during childbirth. It means the baby’s head is too large, or the mother’s pelvis is too small.
A CPD birth can be long and difficult because the baby can’t fit through the pelvic opening. Oftentimes vaginal delivery isn’t successful, so doctors have to intervene. In many cases, the mother will need to undergo a C-section.
Causes of CPD
With CPD, the issue can be with the mother, the baby, or both. These are some potential causes of a CPD birth:
Maternal Causes
- Small stature, or an unusually small pelvis.
- Pelvic exostoses (bony growths on the pelvis)
- Spondylolisthesis (a vertebra slips forward in the spine)
- An abnormally shaped pelvis
Fetal Causes
- Macrosomic baby (large for gestational age, defined as over 8lbs 13 oz)
- Hydrocephalus (the baby has fluid in the brain that causes it to swell)
- Post-term pregnancy (the due date has passed)
Does this mean that every woman of small stature will have CPD? No, not at all. Plenty of women with the conditions mentioned above can deliver their babies vaginally.
Advances in medical technology have significantly reduced the risks associated with CPD. It also helps to catch it early. To do that, doctors and mothers should be aware of CPD risk factors, which we’ll discuss next.
Who is at Risk for a CPD Birth?
A mother won’t be able to tell she has CPD just by looking at her belly. So the burden of detecting CPD and avoiding CPD birth injuries rests on healthcare providers. They must assess mothers for potential CPD during prenatal visits. If there’s any risk, it’s up to doctors to manage it and ensure safety during childbirth.
Doctors should be on the lookout for risk factors like the following:
- Older mother (over 35)
- Short stature
- Gestational diabetes
- Polyhydramnios (having too much amniotic fluid)
- Having a previous C-section
- A male baby
- Calcium deficiency or rickets
How Doctors Manage a CPD Birth
What happens when doctors suspect CPD? They can use radiologic pelvimetry to measure the mother’s pelvis. Also, ultrasounds are a helpful tool for measuring the size of the baby’s head. But these measurements may not be exact. In addition, it’s normal for a baby’s head to change shape a bit when passing through the birth canal.
Considering those measurements and other factors, physicians will conduct a risk assessment. If the risk is too great, they will order a planned C-section.
If it seems safe for the mother to deliver vaginally, doctors will keep close tabs on labor. When labor does not progress or the baby shows distress, the safest intervention is often a C-section.
Injuries from a CPD Birth
Sometimes doctors fail to diagnose CPD or mismanage it. This can be a recipe for disaster. What are some consequences of a mishandled CPD birth? Here are a few examples:
Birth Trauma
CPD can result in birth trauma when doctors use excessive force to try to deliver a baby. This can lead to brachial plexus injuries (nerve damage in the shoulder area), fractures (like clavicle, collarbone, or skull fractures), spinal cord injuries, and soft tissue injuries.
Hypoxia & Fetal Distress
CPD may cause prolonged labor. This increases the risk of oxygen deprivation to the baby (hypoxia), and fetal distress. Insufficient oxygen can damage a baby’s fragile brain and cause lifelong impairment. It can also cause hypoxic-ischemic encephalopathy (HIE), affecting the brain’s ability to control the muscles and body movements, which can then lead to cerebral palsy.
Shoulder Dystocia
During a CPD birth, the baby’s shoulders can become stuck behind the mother’s pubic bone. This situation is called shoulder dystocia. If doctors use too much force when trying to deliver the shoulders, they can cause nerve injuries. Erb’s palsy or Klumpke’s palsy are two examples. They affect movement and sensation in the shoulders and arms.
Uterine Rupture
Forcing a vaginal delivery in cases of severe CPD is a huge mistake. It can put excessive strain on the uterus and cause it to rupture. Uterine rupture can lead to severe bleeding, fetal distress, and maternal injuries.
Postpartum Hemorrhage
Mismanaging a CPD birth can increase the risk of postpartum hemorrhage (excessive bleeding after childbirth). The bleeding can stem from trauma to the birth canal or uterus during delivery attempts.
Legal Help for CPD Birth Complications
By providing appropriate medical care, doctors can prevent the injuries and complications we’ve listed above. Unfortunately, we don’t live in a perfect world with perfect doctors. They are human, and they make mistakes.
Sometimes those mistakes are inexcusable and cause major harm. If you believe medical providers mismanaged CPD birth and injured you or your child, please call us. Hampton & King has over 60 years of experience fighting injustice related to birth injuries. We help families like yours obtain the compensation they need and deserve. Contact us now to get started on your claim.
