North American Registry of Midwives (NARM) Practice Exam

CPD may be evidenced by which of the following signs?

1. Fast labor pattern

2. Poorly flexed head

3. Normal cervical effacement

4. Persistent fetal heart rate variability

The correct answer is: Poorly flexed head

CPD, or Cephalopelvic Disproportion, occurs when the baby's head is too large or the mother's pelvis is too small for a vaginal delivery. One of the classic signs of CPD is a poorly flexed fetal head during labor. A poorly flexed head means that the chin is not tucking down towards the chest as it should, leading to a larger diameter presenting through the birth canal and potentially obstructing progress in labor. In contrast, a fast labor pattern may suggest other issues but doesn't directly indicate disproportion. Normal cervical effacement suggests that the cervix is thinning appropriately but does not provide information about the size relationship between the fetal head and the mother's pelvis. Persistent fetal heart rate variability may reflect fetal distress or other conditions but does not specifically point to CPD. Therefore, the conjunction of a poorly flexed head with other clinical findings can be a key indication of CPD in a laboring patient, making it the most relevant option in this context.