at the end of the class, you will be able to learn knowledge on CPD

1. • https://youtu.be/1l93Ss6gmrE?si=PyDnu_lZ-axeYoC4
• https://youtu.be/ONg2d4u34e0?si=RfIv_8HDzb_brMTx
• https://youtu.be/rLmymm_eMIE?si=Rrx75vxGnIKI1T5t

2. CEPHALOPELIC DISPROPERSION
(CPD)
By
Mallika

3. OBJECTIVES
 To define CPD and contracted pelvis
 to describe the causes and degree of CPD and contracted pelvis
 To discuss the classification of contracted pelvis
 To explain the diagnosis of CPD and contracted pelvis
 To enumerate the effects of contracted pelvis
 To describe the managemnent of the CPD
 to enlist the complications of CPD

4. DEFINITION
• “Anatomically, contracted pelvis if defined as one where the essential
diameters of one or more planes are shorted by 0.5 cm’’
• Obstetrical definition which states that alteration in the size and / or
shape of the pelvis of insufficient degree so as to alter the normal
mechanism of labour in an average size of baby.
• The disparity in the relation between the fetal head and maternal
pelvis called CPD

5. Variations of the female pelvis
• Based on shape of the inlet female pelvis is divided into four types
• Gynecoid
• Anthropoid
• Android
• Platy pelloid

7. Etiology / Causes of CPD
Maternal factors
• Severe malnutrition, rickets, osteomalacia,
bone tuberculosis
• Nutritional and environmental defects major,
minor
• Hereditary factors
• Diseases or injuries- like diabetes, hip bone
fracture
• Developmental factors like-Abnormal shape
pelvis, contracted pelvis
Fetal factors
• Large baby due
• Multiparity
• Abnormal fetal positions

8. Rachitic flat pelvis
• Early childhood bone remains soft and unossified
• Inlet: sacral promontory down ward & forward- reniform shape
• Cavity: sacrum is flat and tilted backwards
• Outlet widening of transverse diameter
• Brim looks like a platy pelloid pelvis
Clinical signs: bow legs, spinal deformity
Osteomalacic pelvis
• Calcium and Vit D deficiency -UK
• Soften bones and bends according to pressure
• Sacral promontory downward & forward
• Sacrum is shortened, pubic arc narrowed and coccyx pushed downwards –Squashed together until
brim becomes Y-shaped – labor is impossible

9. Negels pelvis
• Arrested development of one side of ala – Asymmetric brim
Scoliotic pelvis
• Oblique diameter shorted
Roberts pelvis: Transversely contracted
• Rare malformations formed in failure in development
• Ala of both sides will be absent
• Sacrum fused with innominate bones – due to this abnormal brim prevents
engagement of fetal head- LSCS
Khypotic pelvis – forward angulation
Scolisis – lateral curvature

10. Diagnosis
• Clinical
• Abdominal examinational method
• Abdominal –vaginal ( muller –Munro Kerr)
• Imaging pelvimetry
• Cephalometry: Accurate
• Ultra sound
• MRI: pelvis capacity, fetal size, fetal head volume, pelvis soft tissue
• X-ray

11. Effects
Pregnancy
• It does not have much effect on pregnancy
• Incarceration of retroverted pelvis
• Pendulous abdomen
• Malpresentation-
Labour
• Risk of PROM
• Cord prolapse
• Cervical dilatation is very slow
• Prolonged labour
• Operative interference, shock, PPH, sepsis
Post Birth
• Maternal injuries
• Traumatic birth experience

12. Management
• Preterm birth
• Elective caesarean section at term
• Trial labour