CEPHALOPELIC DISPROPERSION CPD B-IV latest.pptx

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

6. 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

7. 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

8. 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

9. 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

10. 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

11. Management Preterm birth Elective caesarean section at term Trial labour