Shoulder Dystocia occurs during delivery when the shoulder of the infant cannot pass below the pubic bone of the mother following the delivery of the head. This can result in the infant needing to be manipulated to facilitate delivery. If proper steps are not followed, injury to the Brachial Plexus (the nerves connecting the nerves of the arm to the spinal cord) may occur causing Erb’s Palsy.
The American College of Obstetricians and Gynecologists has indicated that shoulder dystocia is often unpredictable. Likewise, ACOG does not recommend induction of labor or plan C-section for fetus’ suspected of having macrosomia, or a large birth weight. However, prophylaxis C-section may be considered for suspected fetal macrosomia when an estimated fetal weight exceeds 5,000 G in women without diabetes or 4,500 G in women with diabetes. 4,500 grams translates to 9 pounds 15 ounces while a 5,000 gram fetus translates to an 11 pound fetus.
Shoulder dystocia is often unpreventable. In reality, there are certain maneuvers or techniques which an obstetrician may perform during delivery of a newborn which increase the risk a child will suffer a brachial plexus injury due to shoulder dystocia. Once stark example is the application of fundal pressure which may worsen impaction of the anterior fetal shoulder behind the mother’s public bone. Fundal pressure is not to be used.
In contrast, ACOG sites the following as reasonable measures for an obstetrician to take in the event of shoulder dystocia:
- Direct fetal manipulation enhanced by the performance of a proctoepisiotomy (an episiotomy that is extended into the rectum).
- Delivery of the posterior arm may also be attempted to alleviate the impaction.
Other techniques which an obstetrician should employ to free the impacted shoulder include the following:
- Moderate suprapubic pressure where an obstetrical nurse or other attendant places a fist above the maternal pubic bone and pushes the fetal shoulder in attempt to change its position and allow delivery.
- The McRoberts maneuver – this technique involves removing the mother’s legs from stirrups and rapidly flexing the legs onto the abdomen.
If the hospital and medical staff present during labor and delivery failed to recognize and react to symptoms of Shoulder Dystocia, your child may have sustained injuries that could have been prevented. If you have questions about birth injuries your baby sustained during delivery due to Shoulder Dystocia, we invite you to contact the law firm of Meyers Evans Lupetin & Unatin.
With over 35 years of experience helping victims of medical malpractice and birth injury, our lawyers are available to give you a free consultation and help you determine if you have a Shoulder Dystocia birth injury case. If you are physically unable to reach us, we will gladly arrange to come to you. The law offices of Meyers Evans Lupetin & Unatin are located in downtown Pittsburgh and are licensed to help victims of medical malpractice throughout the state of Pennsylvania.