Cephalopelvic Disproportion and Obstructed Labour
Cephalopelvic disproportion • Cephalopelvic disproportion (CPD) occurs when the fetal head or body is too large to fit through the mother’s pelvis. • CPD occurs in about 1 out of 250 pregnancies.
Possible causes of cephalopelvic disproportion (CPD) include: • Macrosomia due to: – Hereditary factors – Diabetes Mellitus – Postmaturity (still pregnant after due date has passed) – Multiparity (not the first pregnancy) • Fetal Malpositions • Small pelvis • Abnormally shaped pelvis
How is cephalopelvic disproportion (CPD) diagnosed? • The diagnosis of cephalopelvic disproportion is often used when labor progress is not sufficient and medical therapy such as use of oxytocin is not successful or not attempted. • CPD can rarely be diagnosed before labor begins if the fetus is thought to be large or the mother’s pelvis is known to be small.
Obstructed labour Incidence of about 3% of deliveries • It is failure of descent of fetal presenting part in birth cannal due to mechanical reasons despite good uterine contractions. • Obstructed Labour is a major cause of maternal and perinatal mortality and morbidity in developing countries Possible causes of obstructed labour include : • 1-absolute CPD • 2-abnormal pelvic shape • 2-deep transverse arrest • 3-malpresentation • 4-lower segment fibroids • 5-fetal hydrocephaly • 6-multiple pregnancy with conjoined or locked twins. • 7- Compound presentation
– Maternal A. Bony obstruction - contracted pelvis - tumors of pelvic bones B .Soft tissue obstruction - uterus; impacted subserous peduculated fibroid - cervix- cervical dystocia - vagina- septa, stenosis ,tumors - ovaries- impacted ovarian tumors Causes of obstructed labour:
B. Large size fetus(macrosomia)
- Winter '16
- Bill Oyieke