The Relationship Between CPD/Cord, Head Compression, and Diminished Fetal
Oxygen Reserves

What is Cephalopelvic Disproportion (CPD)?

Cephalopelvic disproportion (CPD) is a
birth injury or condition that occurs when there is a size discrepancy between the
maternal pelvis and the fetal head such that the baby’s head is too
large to pass through the mother’s pelvis. Cephalopelvic disproportion
occurs when the fetal head is too large, the maternal pelvis is too small,
or the fetal head is malpositioned as it enters the birth canal, presenting
a significant risk to both the mother and the child.

Though problematic and potentially dangerous, diagnosing cephalopelvic
disproportion can be difficult in the absence of extreme circumstances
such as an abnormally small maternal pelvis or macrosomia (an abnormally
large child), and often times it can only be identified by abnormalities
in length of labor, abnormal fetal heart tones, or the presence of molding
and/or caput during labor.

A Major Birth Complication of CPD: Head Compression

Perhaps the most significant danger that cephalopelvic disproportion carries
with it is the potential for compression of either the fetal head or the
umbilical cord, both of which can have severe consequences for a child
in labor. Though the causes of cephalopelvic disproportion vary, both
of these risks are still endemic to cephalopelvic disproportion, as the
passage of the fetal head through a limited space can cause compressive
forces to occur to the head itself as well as potentially cause the umbilical
cord to be compressed in the event that it is trapped between the fetal
head and the maternal pelvis during labor. This can lead to
brain damage from direct trauma or from a reduction of available oxygen to the fetus.

Fetal head compression typically occurs in the event that a large amount
of pressure is placed on the skull during labor.

This level of pressure can potentially result in:

  • Fetal nerve damage
  • Skull fractures
  • Intracranial hemorrhage
  • Brain damage such as
    cerebral palsy

Though compression of the fetal head can occur as a result of other factors
as well as in the absence of cephalopelvic disproportion, the risk is
dramatically increased in the event that cephalopelvic disproportion is
a known condition. Cephalopelvic disproportion presents a much higher
degree of risk for fetal head compression, as the delicate fetal head
must pass through a very unaccommodating maternal pelvis in addition to
other potentially traumatic forces that are already present during labor.

Another Major Birth Complication of CPD: Umbilical Cord Compression

Umbilical cord compression is another dangerous condition that is often
associated with cephalopelvic disproportion, as the potential for the
umbilical cord to become trapped between the fetal head or body and the
maternal pelvis is greatly increased when cephalopelvic disproportion
is present. Umbilical cord compression is dangerous and potentially life
threatening in that it can cut off and severely deplete the baby’s
supply of oxygen while in utero. Prolonged compression of the umbilical
cord as a result of cephalopelvic disproportion can have severe consequences,
as a lack of oxygen can lead to
fetal asphyxia and potentially result in hypoxic-ischemic encephalopathy, or “HIE,”
if the oxygen deprivation is too prolonged.

With such severe and potentially damaging risks involved, it is important
the physicians take careful steps in order to determine whether cephalopelvic
disproportion is present prior to attempting a vaginal delivery. Though
making an exact determination of cephalopelvic disproportion may be difficult
prior to delivery, there are still many steps that doctors can take to
gain a sense of the special dimensions that the baby will be navigating
during labor in order to paint a clearer picture of what must be done
to ensure a safe delivery and a healthy child.

How Medical Professionals Can Help Address CPD

Ultrasonographic imaging and ultrasound examinations are both ways in which
doctors can measure the size of the fetal head, and the assessment of
the dimensions of the maternal pelvis through a process known as pelvimetry
are important ways in which a physician may make a more accurate determination
as to the existence of cephalopelvic disproportion. These steps are extremely
important to take in order to protect the child, as without making efforts
towards obtaining a clearer picture of what conditions the baby will face
during labor, it becomes far more difficult to assure a safe delivery
and healthy outcome for the child.

If you experienced CPD and were not given the correct medical care, please
don’t hesitate to
contact our Chicago birth injury law firm.