CPD Diagnosis

Question

I was wondering what tools there were to accurately diagnose CPD or determine pelvis type. 
I recently had a c-section and was told I was unlikely to ever have a vaginal birth in the future.
My baby was 6lbs 12oz.
A little bit of labour story:
I was 6cm dilated and fully effaced when my midwife met me at the hospital at 10am. (my water had broke 12 hours earlier)
Three hours later, I was 9cm dilated and had full uterine activity.
My contractions then slowed drastically. 
I was given an oxytocin drip and an epidural at 430pm.
Later in the afternoon/evening I attempted to push for an hour and half. 
The baby was at -2 stationing, had +2 caput and +2 molding.  
Oxytocin was stopped and waited for the OR to open for a c-section. 
I was given a c-section at 10pm and my baby was delivered in the left occiput transverse position.
The on-call obstetrician told me that my pelvis would likely not allow for a vaginal birth and there was no chance my baby would have descended, however

Dr. Sana Maryam · Answer

Dear, there is no correct tool for measuring CPD, but a trial of labour, sometimes there are more then one factors leading to obstructed labour, that could be your pelvis shape, size, ur baby size, position of head..etc ...
as you told u dilated fully, but baby was at -2 station, and caput was forming, and baby was not descending , so that can be due to both CPD and even malposition of head, like sometimes hard is in such position that it's longer diameter is presenting, so it takes time to either rotate to come in proper position or even sometimes it don't rotates, it stucks there, leading to non- delivery, which we call obstructed labour.
and as you told that during c- section head was in left occipito_ transverse position so most likely baby's head was also not at correct position, so in ur case both factors could be the reason leading to ur c-section.
however don't worry now, it's done, and most probably the obstetrician took good decision for you and your baby.
but in our settings, if one's c- section is done due to CPD or obstructed labour, we don't give her normal delivery trial next time, next one is always a c- section most likely..

Dr. Hina Nadeem · Answer

Aoa
yes occipito-transverse ends up in deep transverse arrest of labour wch v also call failure to progress or failure of second stage of labour...head in such position cant b delivered vaginally as head is presenting wth its maximum diameter tht cant pass thru the comparitively less wider pelvic outlet...now the contributory factors can b the in-efficient uterine contractions or the shape of ur pelvis...in ur case baby is nt big enuf to get stuck...anyways of course ur obstetrician is the best judge but if u ask me if ethg goes normal during ur next pregnancy,i wont ask u to hv another elective CS based on the position of the head of ur previous child...

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Dr. Sana Maryam - Gynecologist

MBBS, FCPS | Islamabad

Dr. Hina Nadeem - Gynecologist

MBBS, MCPS (Obstetrics & Gynecology), PGD(Nutrition), CBC (Advance Ultrasound), | Islamabad

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