Cephalopelvic Disproportion (CPD) Birth Injuries
Cephalopelvic disproportion (CPD) is when the baby's head is mismatched with the mother's pelvis. The disproportionate size will complicate the mother's ability to deliver vaginally and could lead to maternal injuries and fetal distress.
Cephalopelvic disproportion is often the result of medical negligence because the doctor should take action to prevent injuries and protect the safety of the mother and child.
If either you or your child was injured by Cephalopelvic disproportion, you may be entitled to financial compensation.
Peer Reviewed Studies on Cephalopelvic Disproportion
True CPD is a rare condition. According to the American College of Nurse-Midwives, it occurs in roughly one out of every 250 births. Studies show that CPD is a major risk factor that could increase the risk of shoulder dystocia.
According to the American Journal of Human Biology, CPD is caused by a combination of the baby's and mother's size. A large baby or a small mother increases the risks for this condition.
How Is CPD Diagnosed?
When the mother is approaching her due date, the doctor will perform a vaginal exam and measure the pelvic bones. The doctor will also measure the size of the fetus, particularly the head.
The doctor is comparing the size of the baby's head to the area where they would need to pass through before delivery. The doctor may learn more information in an ultrasound, such as observing the size of the baby's head and its position.
If doctors suspect that there may be CPD, they could order a radiologic pelvimetry to confirm their initial diagnosis.
Doctors may use imaging technology, but the most effective way to examine the mother may be physically. This examination is even more critical when there is a large baby. There is a much greater chance that large babies may cause CPD, simply because their head is bigger.
Cephalopelvic disproportion is a matter of size, and there is not much that a doctor can do in the area of treatment. Some doctors may administer Pitocin to facilitate labor and delivery, although that drug comes with its own risks, especially when the doctor gives too much of it.
Risk Factors for Cephalopelvic Disproportion
Here are some of what causes cephalopelvic disproportion:
- Gestational diabetes- elevated levels of insulin can stimulate growth and increase the chance of a big baby with a larger head. The baby is overly large in 50% of pregnancies where the mother has gestational diabetes.
- Genetic factors- some mothers may simply have a genetic predisposition for CPD. Alternatively, the baby could be larger because of hereditary factors.
- The mother's size - shorter women are more at risk for cephalopelvic disproportion because they will likely have a smaller pelvis. One worldwide study found that women under 145 centimeters had double the risk of CPD.
- The baby's position- if the baby is lying sideways, it will make labor and delivery more difficult and increase the chances that they will have a hard time passing through the pelvis.
- Carrying the baby past the due date- the longer the pregnancy lasts, the larger the baby will grow. Doctors may induce labor if the mother is carrying the baby past the medical term in order to reduce the risks that a large baby will pose.
The Risks of Obstructed Labor
Obstructed labor can put both the child's and mother's life in danger. Delivery is an extremely difficult process for the mother and baby. Although it often takes time, the risks increase exponentially when there are extensive delays.
When the baby's head is too large, the delivery will take longer and be far more physically taxing for all involved.
What Prolonged Labor Does to the Baby
The baby's body is also under stress during the labor process, from the very start of uterine contractions. One of the major things that a baby goes through during the delivery is that its head will change shape to accommodate delivery.
The mere act of passing through the pelvis and the birth canal is physically stressful for the baby. The longer the process goes on, the higher the risk factors for a birth injury.
What the Doctor Should Do When the Baby's Head Will Not Fit Through the Birth Canal
The answer in almost every vaginal birth that involves CPD is for the doctor to perform a cesarean delivery. The more time passes after labor begins, the more the baby is at risk. Labor and delivery is a traumatic event for the baby. The minute that it starts, the baby is at risk of suffering an injury.
If the doctor determines that the delivery process is not making progress, the doctor should quickly order a c section. They should be prepared for the prospect because of the work that they did examining the mother and making a CPD diagnosis.
Vaginal Delivery Is Not Always Possible
Most mothers want to deliver vaginally because they feel that natural childbirth is a better experience. However, there are some times when vaginal delivery may not be safe.
The doctor would have the final say when deciding on a c section. The reasonable doctor would resist any pressure and know when to make the final decision about a caesarian section.
They must be prepared to make this decision quickly because time is of the essence.
Complications From Cephalopelvic Disproportion
The baby may suffer serious injury if they have to endure a difficult delivery due to CPD. Aside from the usual bruising and swelling, the baby may suffer a permanent and lasting birth injury.
The most serious birth injury that CPD will cause is to the brain. There are two primary ways that babies may suffer a brain injury in labor. The first is from trauma to the brain when their head is pressed on or struggling to pass through a smaller space. The second is from oxygen deprivation, especially when they have suffered a stroke in utero.
The most common brain injury from a difficult birth is cerebral palsy. This is a movement disorder that can mean muscles that are either too stiff or floppy. The child may struggle to walk and with their fine motor skills and language.
With CPD, the baby could also suffer from shoulder dystocia that could include Erb’s Palsy, and Klumpke’s palsy. Shoulder dystocia could also cause oxygen interruption that could result in a fetal stroke.
Finally, babies could also be injured by a prolapsed umbilical cord. With less room to move, the baby could become trapped and suffer a cutoff of oxygen that will cause brain damage.
How CPD Affects the Mother
One of the major impacts on the mother is that they may have difficulties with subsequent pregnancies. CPD could cause permanent damage to the mother's pelvis. In the worst-case scenario, the mother may suffer birth canal trauma, postpartum hemorrhage, and genital infections.
The biggest worry when CPD is diagnosed is the health of the baby.
CPD can also cause nerve damage to the mother that could make future deliveries more difficult. Some doctors may advise a cesarean section without even trying for a vaginal birth in a future pregnancy. However, CPD in the first pregnancy is not a guarantee that it will happen again in the future.
However, there is no guarantee that the mother will experience CPD in future pregnancies. Many women are able to have a vaginal delivery in the future.
Proving Medical Negligence in a Birth Injury Case
In a birth injury case, you must prove that the doctor acted unreasonably under the circumstances. You would compare what your doctor did to what a doctor of average training would do. If what your doctor did would fall short, then they may be considered negligent.
In the case of CPD, the main way that a doctor is negligent is by not electing for a cesarean birth in time when they have initial concerns about the baby's position. The doctor may not anticipate CPD because they failed to perform a proper pelvic exam and measurement of the baby before delivery.
You should contact a birth injury attorney to learn more about whether and how you can hold the doctor legally and financially accountable for CPD-related injuries.
Cephalopelvic Disproportion Attorneys Helping Families
When your doctor has failed to act reasonably and has caused injuries through their medical malpractice, the attorneys at Rosenfeld Injury Lawyers can help your family recover financially. We help families like yours that are dealing with the effects of birth injuries.
An attorney client relationship with our lawyers means that you will get attentive service and a zealous advocate who will work to hold the doctor legally accountable. Call us today at (888) 424-5757 or contact us online to schedule your free initial consultation.