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Cephalopelvic disproportion

Claire999999Claire999999
in C-sections

I know that TRUE CPD is rare, but in cases of it or in cases of failure to progress where CPD is diagnosed, where is the baby usually in the birth canal when this is diagnosed? Is the head visible yet?


Also, if CPD has not been definitely diagnosed but there is a failure to progress and a c-section is required, does that usually mean that the head wasn't far enough along in the birth canal for a vacuum or forceps extraction to be done?

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Re: Cephalopelvic disproportion

  • annabelle.27annabelle.27 member

    No, the head would not be visible- the head would not have left the uterus yet, I believe. If the head is visible the baby is already almost out, and the head has already passed through the pelvis.

    No, forceps or vacuum would not be helpful. If the pelvis is TRULY too small for the head to fit through, sticking forceps up there wouldn't help.

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  • iris427iris427 member

    I'm not a doctor or midwife but it's my understanding that the narrowest part of the pelvis is at 0 station.  So theoretically, in a case of true CPD, the fetal head would not descend much lower than 0 station.

    If the head is visible, then it has passed through this part of the pelvis, so CPD is probably not an issue.  By the time the head is visible, baby is at +3/+4 station.  Here is a good diagram of pelvic station in relation to the mother's anatomy:

    https://www.trialsightmedia.com/exhibit_store/images/stations.jpg

     Also, if CPD has not been definitely diagnosed but there is a failure to progress and a c-section is required, does that usually mean that the head wasn't far enough along in the birth canal for a vacuum or forceps extraction to be done?

    Probably but not necessarily.  For example, sometimes arrest of descent is caused by fetal positioning like OP position.  Some doctors may try to manually rotate the baby with forceps while others may recommend a cesarean.   In true CPD, vacuum and forceps will not help.

    I had a c/s for CPD and baby was at 0/+1 station and was OP position.  (My 2nd delivery was a VBAC of a bigger baby, so I don't think I really had CPD).

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