I don't think there really is a definitive way to diagnose CPD, prior to labor. Some studies have been done using pelvimetry (Xrays of the pelvis). But, they have not shown to improve or effect outcomes, whether delivered by CS or vaginally. A presumptive diagnosis can be made during labor if there is secondary arrest of dilatation (no cervical change over a period of time, with adequate contractions), or arrest of descent at +2 or +3 station.
We generally think of macrosomic infants with shoulder dystocia first, when we think of CPD. But there can be other diagnoses that "cause" (or at least, result) in FETO-PELVIC disproportion, including malpresentations (face, brow, transverse, OP), congenital anomalies (hydrocephalus, ascites, organomegaly), an unengaged head in a nulliparous Mom, soft tissue obstruction (fibroids, enlarged bladder, ovarian cysts, impacted feces), problems with contractions (uterine inertia, inadequate abdominal muscles, ventral hernias, bicornute uterus.
|
Would you like to comment?
