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Shoulder Dystocia

Shoulder dystocia occurs when during delivery, the infant's head is delivered but the infant's anterior shoulder gets caught below the mother's pubic symphysis or pubic bone. In a normal delivery, the rest of the infant follows smoothly out of the vagina after the head is delivered. However, when shoulder dystocia occurs, the initial signs that a physician will see is the "turtle sign," which is the protrusion and retraction of the infant's head, and facial flushing of the child.

Possible Injuries Due to Shoulder Dystocia

If shoulder dystocia is not caught in time, the baby can suffer damage to the upper brachial plexus nerves, which are nerves that start from the spinal cord and run through the arm. Damage to these nerves could potentially prevent the infant from moving the arm, grabbing objects, and extending the arm. Some of the injuries that can result include the following:

  • Fractures, where due to the pressure of the newborn's shoulders against the mother's pelvis, the clavicle or collar bone breaks.
  • Erb's Palsy, which consists of the partial or complete paralysis of the arm. Please see the Erb's Palsy article for a detailed discussion of the Erb's Palsy condition.
  • Klumpke's Palsy, which consists of the paralysis of the forearm and hand muscles.
  • Fetal asphyxia, which can lead to neurological damage and possibly fetal death.

Risk Factors

If an obstetrician is monitoring the mother and fetus carefully, there are certain noticeable warning signs or risk factors that can alert the doctor to the likelihood of the occurrence of shoulder dystocia during delivery. Some of the risk factors include:

  • Macrosomia, which occurs when babies are large for their gestational age.
  • Cephalopelvic Disproportion, which occurs when the newborn's head is too large to move through the mother's pelvis.
  • Maternal obesity.
  • Advanced maternal age.
  • Gestational diabetes.
  • Stalled labor or prolonged second stage of labor.
  • Overdue gestation, or post-term gestation.
  • Delivery of large infants during previous pregnancies.
  • Delivery of infants in the past who had brachial plexus injury or a fractured collarbone.

Obstetrical Procedures for Shoulder Dystocia

Physicians have an array of methods available to them to avoid further injury to the baby once the possibility of shoulder dystocia is detected. One option that has been used by some pregnant mothers in the past is a cesarean section.

If you or someone you know has given birth and injury resulted to the child due to shoulder dystocia, speak to experienced attorneys who have successfully represented clients in shoulder dystocia cases. Contact Anderson Law Offices, LLC for a free initial consultation.

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