CEPHALOPELVIC DISPROPORTION

What is the head and pelvic incompatibility between the head of the fetus in the womb and the pelvic structures that form the birth canal of the mother. What is meant by the pelvic structure is the bones surrounding the mother's hip joints and birth canal. However, the birth canal is not only surrounded by bone structures. The soft tissue and muscle structure here can also affect the shape and structure of the birth canal. Therefore, these are included in the definition of head pelvis incompatibility.
(CPD = Cephalopelvic Disproportion)
What is meant by nonconformity is dimensional or positional nonconformity. The baby's head is larger than the mother's birth canal or enters the head canal in a different position than it should be, or the pelvic structure of the mother is abnormal in shape. Both conditions make it difficult or completely prevent birth and progression of the head in the birth canal. Bone diseases, such as Rikets disease and trauma fractures, can disrupt the shape of the hip bones, causing CPD.
It is a condition that occurs in 1-10% of all births on average. A mother who is diagnosed with head pelvis incompatibility (BPU, CPD) at one birth can give a normal birth at later births. The harmony of the baby's head and pelvic structure may differ at each birth.
Diagnosis:
Methods used today to diagnose head pelvis incompatibility:
- Examination: Evaluation of the fetal head and the pelvic structure of the mother is the most important criterion in diagnosis. In this examination, the size of the head, posture, asynclitism, pelvic bone structures of your mother, and the opening at the exit of the pelvis and its exit are evaluated.
- Ultrasonographic pelvimetry: Compares pelvis diameter measurements with fetal head diameter measurements.
Structures that make up the bone pelvis:
- Pubic bones
- Sacrum
- Coccyx
- Ilium and ischium bones are located on the outside of the birth canal.
Application of cesarean section in head-pelvis incompatibility:
 Since the incompatibility of the head pelvis is a condition that prevents delivery by normal vaginal route, delivery by cesarean is required. In the very old years when cesarean surgery could not be performed, births were excessively prolonged due to incompatibility of head pelvis, and therefore, maternal and infant deaths occurred in large numbers. Serious complications can occur, including maternal or infant death, if the delivery is not terminated by caesarean delivery (or craniotomy or symphysiotomy) in a non-progressive delivery.
Getting pregnant at an early age, i.e., getting pregnant within 3-5 years after a girl starts having her period increases the risk of CPD. Because in these years, the pelvic bones are still developing and are not fully mature. Bone pelvic structures of young girls are also short and inappropriately due to poor nutrition, especially in developing poor countries. In these countries, CPD and many related complications (such as fistulas) occur frequently due to early pregnancy.
Complications that may develop due to head pelvis incompatibility:
- Fetal anoxia and death
- Maternal death (mostly due to bleeding and infection)
- Uterine atony and excessive postpartum bleeding
- Puerperal infections
- Vesicovaginal fistula
- Rectovaginal fistula
- Chronic pelvic pain
- Uterine rupture (especially in multigravida)


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