SHOULDER DYSTOCIA BIRTH INJURY & SHOULDER DYSTOCIA DEATH

What Is Shoulder Dystocia?

Shoulder dystocia is a type of birth injury that happens when one or both baby’s shoulders get stuck inside the mother’s pelvis during birth. Generally, most babies are born safely even if their shoulders get stuck. Still, this type of birth trauma can cause serious issues for both mom and baby.

How Common is Should Dystocia?

Shoulder dystocia is fairly rare, and only happens in 0.2-3% of pregnancies. Shoulder dystocia death is also very uncommon, happening in approximately 0.4% of birth traumas.

What are the Risk Factors Associated with Shoulder Dystocia?

Shoulder dystocia can happen to any mother and baby. However, some women are more at risk for this type of birth trauma compared to others.

The most common risk factors associated with shoulder dystocia include:

• Macrosomia:This occurs when a baby weighs more than 8 pounds, 13 ounces. However, most vaginally born babies with macrosomia don’t have shoulder dystocia. This is because most cases of this type of birth trauma are associated with babies of normal weights. Still, macrosomia can raise risks, as mothers will have more trouble pushing larger babies.
• Diabetes: Having preexisting diabetes or gestational diabetes is also a risk factor for shoulder dystocia.
• Previous Should Dystocia Injuries: having a child with shoulder dystocia in a previous pregnancy can raise your chances of having this kind of birth trauma with a later pregnancy.
• Carrying twins, triplets, or other multiples raises your chances of shoulder dystocia.
• Being overweight or gaining too much weight during pregnancy is another risk factor.

Labor Specific Conditions

Conditions that are specific to labor and birth can also raise your risk of shoulder dystocia.

These conditions include:

• Receiving oxytocin to induce labor can raise your risks of shoulder dystocia.
• Getting an epidural to reduce pain during labor can also raise risks of shoulder dystocia.
• Having a very short or very long second stage of labor. This is the part of labor where a woman starts pushing to give birth.
• An assisted vaginal birth, also called an operative vaginal birth, can raise your chances of shoulder dystocia. In an assisted vaginal birth, a doctor will use tools such as forceps or a vacuum to pull a baby through the birth canal. With forceps, the doctor will put them around the baby’s head to guide the it out of the vaginal canal. Meanwhile, a vacuum is a suction cup that goes around the baby’s head to guide it out of the vaginal canal.

Shoulder Dystocia Symptoms

The most common symptoms of shoulder dystocia include:

• When the baby’s shoulders don’t descend
• Difficulty in face and chin delivery
• Retracting difficulties
• Fetal head restitution failure
• Downward traction on the fetal head

Postpartum Side Effects of Shoulder Dystocia?

Most moms and babies fully recover from shoulder dystocia, but here are the most common problems they may face after this type of birth trauma:

Shoulder Dystocia Complications for Baby

• Collarbone and arm fractures is a common result of shoulder dystocia.
• Brachial plexus nerve damage, also known as Erb’s palsy. These nerves extend from the spinal cord in the neck and down the arm.
• Asphyxia, also known as lack of oxygen to the body. In severe cases, this can cause injury or shoulder dystocia death. But asphyxia is very rare.
• Pneumothorax, which is a collection of gas between the chest wall and the lungs.

Shoulder Dystocia Complications for the Mother

• Postpartum hemorrhage, which is heavy bleeding after birth.
• Severe tearing of the perineum, which is the stretch of skin between the vagina and the rectum.
• Uterine or bladder rupture which is a rare condition when the uterus or bladder tears during labor.
• Cervical tears, which is when the cervix tears during birth.
• Dislocation of the sacroiliac joint, which happens when both the anterior and the posterior columns of the pelvic ring are disrupted. When this happens, the hemipelvis rotates internally with vertical displacement.
• Symphyseal separation is the excessive movement of a part of the pelvis called the pubic symphysis.

How to Prevent Shoulder Dystocia

If your doctor thinks you may be at risk for shoulder dystocia, they can try several methods to move you and your baby into a better position during labor. Your doctor might try:

• The McRoberts maneuver, which is when you press your thighs against your belly.
• Suprapubic pressure, which is when your doctor presses on your lower belly above your pubic bone.
• Helping your baby’s arm out of the birth canal.
• Reaching into the vagina to attempt to turn the baby.
• Turning a mother onto all fours.
• Giving an episiotomy, which is a surgical cut at the vaginal opening during childbirth. This is generally not a routine method. It’s only done when a larger opening would be helpful during birth.
• Performing a C-section to prevent the baby’s shoulders from getting stuck in the pelvis.

Treatment for Postpartum Shoulder Dystocia Side Effects

If shoulder dystocia isn’t resolved during labor, both mother and baby can suffer painful postpartum side effects.

Treatment for the Baby

Because there are many possible side effects from shoulder dystocia, there are dozens of treatments available for mother and baby.

Collarbone and Arm Fractures

Usually, no treatment is advised for collarbone and arm fractures in babies because they heal quickly without issues. But if the fracture is severe, the parent must pin the baby’s arm sleeve to the front of its clothing to attempt immobilization while healing.

Erb’s Palsy

For Erb’s palsy, the most common treatment is to keep the affected arm moving. Parents must play a major role in moving the baby’s arm for healing. If the nerve damage is severe, babies may need surgery to repair it.

Asphyxia

For birth asphyxia, treatment depends on the severity of the condition. Immediate treatment after birth includes:

• Providing the mother with extra oxygen if the asphyxia happens before delivery
• Suctioning fluid away from the baby’s airways
• Putting the baby on a respirator

However, severe treatment for asphyxia requires specialized treatment, including:

• Putting the baby in a hyperbaric oxygen tank
• Induced hypothermia to cool the baby and help prevent brain damage
• Medication to regulate blood pressure
• Dialysis to support the kidneys and remove excess waste from the body
• Medication to control seizures
• IV nutrition
• A breathing tube with nitric oxide
• Life support with a heart and lung pump

Pneumothorax

Finally, a pneumothorax in a baby is treated by providing extra oxygen and removing the extra air from the chest.

Treatment for the Mother

All Tears from Birth

Stitches and rest can fix all types of tears due to childbirth. However, a ruptured uterus or bladder during birth is treated differently. The rupture is usually repaired with surgery. For severe ruptures, a hysterectomy may be necessary.

Postpartum Hemorrhage

Medication, manual uterine massage, removal of placental pieces inside the uterus, and tying off bleeding blood vessels are common treatments for postpartum hemorrhages. In more serious cases of postpartum hemorrhage, a hysterectomy may be necessary.

Sacroiliac Joint Dislocation

Nonsurgical treatments for a dislocated sacroiliac joint include physical therapy, chiropractic manipulation, and stretching. But for a severe dislocation, a mother may need a minimally invasive sacroiliac joint fusion surgery.

Symphyseal Separation

Lastly, mothers suffering with postpartum symphyseal separation due to shoulder dystocia will need bedrest in the side position, pelvic support with a brace or girdle, and physical therapy.

How Does Medical Malpractice Cause Shoulder Dystocia Injury or Shoulder Dystocia Death?

In some cases, medical malpractice causes shoulder dystocia. If your doctor doesn’t act quickly or appropriately in response to shoulder dystocia, you may be able to file a medical malpractice lawsuit.

Doctors can generally face two types of malpractice claims associated with shoulder dystocia cases:

• Excessive force: shoulder dystocia during birth may have been caused because your doctor used excessive force while trying to deliver the baby in a better position.
• Failure to expect shoulder dystocia: your doctor should expect shoulder dystocia due to the presence of certain risk factors. A lawsuit based on this allegation claims that a doctor should’ve offered specific types of delivery to avoid the possibility of shoulder dystocia.

Damages for a Shoulder Dystocia Case

If your baby suffered a shoulder dystocia death or you suffered major injuries as a result of birth trauma, you are eligible for compensation.

Types of compensation you can receive are:

• Past and present medical expenses. This includes costs of physical therapy, surgeries, adaptive equipment, counseling, and more.
• Lost wages from you or your child’s injury.
  Future earnings losses if you or your child can’t work in the future due to injuries.
• Pain and suffering, including emotional distress and loss of quality of life.

Is Shoulder Dystocia Death Possible?

Shoulder dystocia death is often preventable, but very possible. The most common cause of shoulder dystocia death is asphyxia, which can lead to brain injury or death if doctors respond quickly or correctly. Death from this type of birth trauma only happens in about 0.4% of cases.

However, if your baby is in that slim statistic, a Houston medical malpractice attorney wants to fight for you. We understand that your family and your baby are much, much more than a statistic. And, we have the resources available to fully investigate your case.

Houston Medical Malpractices Lawyers for Shoulder Dystocia Injuries

Without a background in medicine, it can be difficult to know if the hospital or pharmaceutical staff was negligent before or during labor that led to shoulder dystocia. Our lawyers can help evaluate the specifics of your case and also file a claim if medical malpractice was a factor.

At Reich & Binstock, our attorneys care deeply about making sure our clients receive justice.

Call us today for a free consultation at 713-622-7271 or complete our confidential online form for information about shoulder dystocia claims.