Cephalopelvic disproportion (CPD) exists when the capacity of the pelvis is inadequate to allow the fetus to negotiate the birth canal. This may be due to a small pelvis, a nongynecoid pelvic formation, a large fetus, an unfavorable orientation of the fetus, or a combination of these factors. Certain medical conditions may distort pelvic bones, such as rickets or a pelvic fracture, and lead to CPD.

Transverse diagonal measurement has been proposed as a predictive method.

1. Prolonged Labor: Labor that does not progress as expected, particularly during the active phase.

2. Failure to Progress: Lack of dilation or descent of the baby despite strong contractions.

3. Severe Pain: Intense pain that is disproportionate to normal labor pain.

4. Fetal Distress: Signs like abnormal heart rate patterns detected via fetal monitoring.

5. Maternal Exhaustion: Extreme fatigue in the mother due to prolonged labor.

6. High Station: The baby's head remains high in the pelvis and doesn't descend despite strong contractions.