One of the potential pregnancy and birth dangers that OB/GYN doctors and labor and delivery nurses need to look out for is if the baby’s head is too big to pass through the mom’s birth canal. This is a medical condition called cephalopelvic disproportion, and it affects about 1 in every 250 American pregnancies.
Even with good prenatal care, it’s rare for cephalopelvic disproportion to be diagnosed before real labor starts. The reasons for this lie in the marvelous way that natural labor works.
The pelvic joints of the mother move to allow more room for the baby’s head. And the baby’s head contracts or squeezes together, called molding, during labor and delivery—the fetal head can do this because the fontanelles, or soft spots, of the skull aren’t fused. Until the impact of these two changes can be observed, it’s usually premature to diagnose cephalopelvic disproportion.
Even though the formal diagnosis usually can’t be made in advance, some signs of an increased risk of cephalopelvic disproportion can be seen prenatally or during labor and delivery. These include:
• A large fetal size is measured on ultrasound
• The mom has a naturally small or unusually shaped pelvis
• Physical exam shows an abnormally-high fundal height, which is the difference between the pubic bone to the top of the uterus
• The due date has passed (post-term or post-maturity)
• The baby has an abnormal position in the womb
• High levels of amniotic fluid
• Failure to progress in labor, meaning that it’s a lasting longer than expected
During labor and delivery, the standard of care requires the physician and nurses to monitor the baby’s wellbeing continuously.
Fetal heart monitoring equipment helps identify if the baby is having difficulty coping with the stresses of labor, the placenta is failing, or if there is inadequate oxygenation. This is called fetal distress, and can be caused by a number of different conditions, including cephalopelvic disproportion. When there’s a sign of feta distress, it’s time for the doctor and nurses to jump into action.
Once the obstetrician makes the diagnosis of cephalopelvic disproportion, it’s unsafe to proceed with natural delivery. It’s important for the safety of the baby and mother for the diagnosis to be made timely and then for the labor and delivery team to convert to cesarean section (C section) delivery as soon as possible.
If you, your child, or someone you care for has been seriously injured because of medical or nursing mistakes in diagnosing or managing cephalopelvic disproportion, or in labor and delivery, then contact a top-rated Houston, Texas medical malpractice lawyer for help in evaluating your potential birth injury case.