Shoulder dystocia is a birth injury that occurs when one or both of the baby's shoulders become obstructed by the mother's pelvic bone, preventing the baby from passing below.
Shoulder Dystocia Medical Malpractice
Shoulder dystocia can be the result of a baby too large to fit through the mother's birth canal, a condition doctors should be able to assess and plan for prior to birth. Shoulder dystocia can also occur spontaneously during birth. When this happens, doctors should be prepared to manage the condition with a variety of techniques that can prevent harm to both the baby and the mother.
If doctors fail to promptly alleviate symptoms of shoulder dystocia and to act quickly to relieve the stress on the baby, the baby could suffer serious and permanent damages.
In Maryland, Shoulder Dystocia is a common birth injury that can result in medical malpractice liability when a doctor fails to properly diagnose conditions that would cause it, and also when a doctor fails to act to prevent injury to the baby once the symptoms present. If your baby suffered from Shoulder Dystocia in Baltimore or anywhere else in Maryland, we can help you understand whether you have a case.
Shoulder Dystocia occurs in up to 3% of all births. It is the most common reason for obstetric malpractice claims.
Duty To Diagnose Shoulder Dystocia To Avoid Medical Malpractice Liability
There are clear signs that a baby is suffering from shoulder dystocia. A common sign is failing to progress during labor. Once the baby's head crowns, the baby's head should follow within about one minute. Otherwise, the baby is at risk. While in the birth canal, the umbilical cord can be compressed, cutting off vital oxygen to the baby. Therefore, if the baby's body does not follow within five minutes and maneuvers have not been attempted to alleviate the problem, the baby could be at risk for significant oxygen deprivation.
With should dystocia, it is also common to see the "turtle sign." This is when the baby's head retracts back into the birth canal after the breech. During labor, the baby's shoulders should rotate to fit through the birth canal. If they fail to rotate properly, the baby can get obstructed by the mother's pelvic bone.
Risk Factors For Shoulder Dystocia Your Doctor Should Recognize To Avoid Medical Malpractice
At least 50% of all shoulder dystocia cases are unpredictable and will require emergency interventions. About 10% of cases show early symptoms and are preventable. In this regard, there are certain risk factors your doctor should consider. These include:
- Weight of the baby- this is the most common factor in cases of shoulder dystocia, and it is predictable if the doctor properly monitors the baby in utero. Studies have shown that larger babies are at a greater risk of shoulder dystocia. The incidence rate ranges from 1.4% for babies up to 5lbs 8 oz, to 9% for babies over 9lb 14 oz.
- Previous history of shoulder dystocia
- Macrosomia- the baby's body is disproportionally large compared to its head
- Post-term baby- the baby is over its due date
- Diabetes- the risk of shoulder dystocia is doubled for women with diabetes
- Misuse of assisted delivery tools like forceps or vacuum extractor tools
Treating Shoulder Dystocia
There are several maneuvers doctors can use to alleviate and prevent shoulder dystocia during labor and delivery. Doctors should immediately stop the mother from pushing because pushing can result in additional stress on the baby. Several maneuvers can be employed to manipulate the mother's abdomen and/or the baby's position in order to encourage passage.
The McRoberts maneuver involves hyperflexing the mother's thighs against her abdomen. This changes the shape of the birth canal, potentially easing passage for the baby. This maneuver is successful in about 50% of all cases.
Doctors may also try various rotational maneuvers on the baby to rotate its shoulders into a different position. These maneuvers have the potential to dislodge the baby's shoulders or to cause fractures or breaks in the clavicle or humerus.
If all maneuvers fail, doctors can push the baby back into the birth canal and perform an emergency C-section.
Medical Malpractice Damages and Effects of Shoulder Dystocia
Effects of shoulder dystocia range from minor to permanent. A brachial plexus injury, also called Erb's palsy, is a serious and common injury associated with shoulder dystocia. Erb's palsy is defined by the loss of function and feeling caused by nerve damage. It occurs in 2-16% of all shoulder dystocia injuries. Up to 30% of all brachial plexus injuries are permanent. Shoulder dystocia doubles the risk of a baby suffering from a brachial plexus injury.
Shoulder dystocia can prolong the labor and delivery process, which presents risks to both the baby and the mother. Labor is considered prolonged if it lasts over 20 hours. During prolonged labor, babies have a greater chance of developing fetal distress and of being subjected to reduced oxygen levels, among other risks.
Mothers also risk complications from a prolonged labor, including infection, blood loss, and lacerations.
Baltimore Shoulder Dystocia Lawyers
The Maryland Birth Injury Attorneys at Gilman & Bedigian are dedicated to helping your family through the difficulties through the trauma caused by medical malpractice. If your child suffered shoulder dystocia during birth and is seriously injured, contact us today to learn about your legal options.