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Loice Vavi

Health Matters

CPD is a child birth complication that occurs when there is mismatch between the size of the foetal head and the size of maternal pelvis resulting in failure to progress. 

The consequence of CPD is obstructed labour that can endanger the lives of both mother and the foetus.

CPD is the leading cause of obstructed labour or long term disability.

Causes

Maternal’s anatomy does not match the size of the foetal head through the birth canal due to contracted abnormally shaped pelvis.

Can be caused by genetics for example rickets, pelvic tumours, previous injury to the pelvis or accident.

Gestational diabetes which lead to macrosomic babies or big babies. 

Small pelvis.

Post-dates (being pregnant after the anticipated gestational age, past 3rd trimester.) The baby grows larger than normal.

Maternal age over 35 tend to have big babies which increases the risk of CPD.

Position of the foetus usually malpresentation.

Hereditary conditions that cause the baby to be larger than normal and conditions such as hydrocephalus that makes their head larger.

Obesity — women who are obese tend to carry and give birth to big babies.

Diagnosis

CPD is diagnosed during labour either by slow progress or no progress even after acceleration of labour. It is rarely diagnosed before labour begins and when the baby is big (macrosomia) and the mother’s pelvis is known to be small.

Management 

Management depends on severity and when it is diagnosed. The goal is to have a safe delivery.

Possible risks and complications of CPD

Birth injuries.

Head injury.

Shoulder dystocia.

Increased risk of still birth.

Infections of the uterus and bladder.

Bladder and rectum trauma.

Ruptured uterus, bleeding, shock and death.

It is important to make informed decisions considering possible risks and complications.

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