An Ohio jury has awarded a local couple $1.63 million in a lawsuit filed against two doctors that delivered their son four years ago and allegedly caused him injury. The lawsuit claims that the mother requested a Caesarian section due to the size of the baby, but the doctors refused. While birthing the baby vaginally, the child’s shoulder became caught, causing permanent injuries to his right arm. The jury found in their verdict that both the doctors were negligent in caring for the woman and baby. Kimball Perry, The Cincinnati Enquirer
Birth injuries are commonly the result of . Shoulder dystocia is a medical emergency in which the baby’s shoulder gets stuck during birth behind the mother’s pubic bone. Typically this also involves a delay in time between delivery of the head and delivery of the body.
Most cases occur with no warning, but the overall incidence of shoulder dystocia varies based on fetal weight. It is more common in infants born to women with diabetes who tend to have larger babies.
Complications resulting from shoulder dystocia can affect both the mother and the infant. The most common fetal complications are palsies. Luckily these palsies typically resolve within 6-12 months and fewer than 10 % result in permanent injury.
Other complications include fracture of the clavicle or humerus, contusions, fetal asphyxia, and maternal injuries such as excessive blood loss and vaginal or vulvar lacerations. Post partum bladder atony is also seen in many cases.
Some risk factors for shoulder dystocia are:
A history of shoulder dystocia in a previous delivery
Obesity in the mother
Maternal age (as it relates to obesity, weight gain, diabetes, and deliveries with instrumentation)
An abnormal pelvis
As a Nurse Life Care Planner, I am often called upon to prepare care plans which outline the long term care of these infants with birth injuries such as shoulder dystocia. For those with plexus injuries, treatment is usually therapy and occasionally nerve exploration. For those with asphysia the treatment can be very complex. The lack of oxygen might result in brain injury, seizures, nerve and muscle defects which make for life long treatment.
Shoulder dystocia is a medical emergency and an obstetrician’s worst nightmare. Know the risk factors. Know the signs. Care for the infant.