Cephalopelvic Disproportion: A Leading Cause of Prolonged Labor and Preventable Birth Injuries

While the vast majority of babies are born healthy and without issues, many problems can arise during labor and delivery. Cephalopelvic Disproportion or CPD – when a baby cannot make its way down the birth canal – is one of those issues. In a true case of CPD, repeated attempts to deliver vaginally will only prolong labor in a way that could prove dangerous to both mother and child.

Our Birth Injury Lawyers have extensive experience representing infants harmed due to medical malpractice. If you experienced CPD and your child suffered a birth injury as a result, please call our law firm toll-free at 877-875-2927 to speak with an attorney and learn more about your legal rights.

What Causes CPD?

CPD occurs when a baby’s head is too large to pass through the mother’s pelvis and into the birth canal. Certain risk factors increase the potential for CPD in pregnancy, including:

  • Fetal macrosomia, or an abnormally large baby weighing over 8 lbs. 3 oz. Macrosomia occurs in about roughly 10% of pregnancies.
  • Pelvic abnormalities, such as a small or unusually shaped pelvis (either due to prior injury or genetic factors).
  • Gestational diabetes, which often leads to increased birth size or weight. About 50% of pregnancies affected by gestational diabetes result in macrosomia.
  • Polyhydramnios, or the presence of excess amniotic fluid.
  • Post-term pregnancy, in which gestation extends beyond 39 weeks.
  • Abnormal fetal positioning, as delivery is easier when the smallest part of the head (occiput anterior) leads the way.
  • Hydrocephalus and other congenital abnormalities affecting a newborn may result in a large-than-normal head.
  • Since boys tend to be larger than girls, the risk for CPD increases slightly with boys.
  • First pregnancy or previous C-section.
  • Teen pregnancy, where the pelvic bones haven’t yet fully grown.
  • History of fertility treatments.
  • Malnutrition or obesity affecting the mother.
  • Mother is short in stature.
  • Hispanic heritage.

CPD occurs in around 1 in every 250 pregnancies. Fortunately, when one pregnancy results in CPD, it doesn’t necessarily follow that subsequent pregnancies will lead to similar complications. In fact, according to one recent study, more than 65% of women diagnosed with CPD eventually gave birth to another child vaginally.

How is CPD Diagnosed?

CPD is occasionally diagnosed prior to labor when a doctor identifies risk factors with the mother or notices that the baby is unusually large or in an abnormal position during a prenatal exam. In such cases, the doctor might recommend trying to reposition the baby before the due date or scheduling a C-section to avoid the potential complications and birth injuries associated with CPD.

However, most cases of CPD are diagnosed during labor when the newborn is not progressing through the pelvis and into the birth canal as it should. Therefore, OB/GYNs must remain vigilant for signs of CPD in the delivery room, including:

  • A prolonged labor that is lasting longer than expected.
  • Weak contractions that are unable to keep the labor progressing
  • Slow thinning and dilation of the cervix, or none at all.
  • The baby’s head is not engaging or entering the pelvis.
  • The baby is not moving down through the pelvic stations.

What Complications and Birth Injuries are Associated with CPD?

Cephalopelvic disproportion is the leading cause of obstructed labor and, without appropriate intervention, may result in maternal death, stillbirth, or long-term disability. Serious CPD complications that can affect the mother include:

  • Infections of the uterus, bladder, or vaginal walls
  • Trauma to the bladder or rectum
  • Ruptured uterus, which can cause a hemorrhage, shock, or death

Birth injuries and newborn complications associated with CPD include:

Fortunately, there is no evidence to suggest that CPD poses any risks to the mother or baby when the condition is diagnosed correctly, and appropriate action is taken in a timely manner.

How Should Doctors Approach CPD?

When severe CPD is diagnosed early, a doctor will likely recommend a planned C-section. In other cases, CPD may be treated with a symphysiotomy (the surgical division of pubic cartilage) or an emergency C-section after a trial of labor.

While most instances of CPD are diagnosed during labor and typically treated via emergency C-section,  an obstetrician may first attempt to use tools like forceps or vacuum extractors to reposition and guide the baby past the mother’s pelvis. However, these techniques are rarely effective and may further prolong labor to the detriment of both mother and child.

If a doctor fails to diagnose CPD, they may choose to administer labor-inducing drugs (such as Pitocin and Oxytocin) to speed delivery. However, these drugs are of little help when CPD is the reason for a prolonged labor. Moreover, their overuse may cause excessive and traumatic contractions that could injure the baby.

Contact an Experienced Child Injury Lawyer

Child Injury Lawyer Jeffrey Killino believes newborns harmed by medical malpractice and their families deserve compensation for their pain and suffering. If your son or daughter suffered a severe or fatal birth injury due to a doctor’s failure to properly diagnose or treat CPD, our child injury law firm is ready to help you pursue a personal injury or wrongful death lawsuit against those responsible. Please don’t hesitate to contact us at 1-877-875- 2927.