Back to the Basics – The Dangers of Shoulder Dystocia

Shoulder dystocia is a rare, but potentially serious condition that occurs when a baby gets stuck during delivery. According to the health website, shoulderdystociainfo, the condition starts as a normal delivery. Once the head is delivered, the process stops because the baby’s anterior shoulder gets caught on the mother’s pubic bone. If the shoulder is not freed quickly, the result can be brain damage or even death. Of the approximately 4 million births in the United States, about 20,000 of these women experience shoulder dystocia.

The size of a baby’s head, shoulder and chest is key to the ease or difficulty of the delivery. Generally, the fetal head is the largest of these body parts. Therefore, once it moves through the birth canal, the shoulders and chest easily follow. However, when the shoulders or chest are similar in size to the head, an increased risk of dystocia occurs. When this does occur, it is usually in larger babies or mothers with a diagnosis of diabetes. For larger babies, the access growth is often seen in the shoulders and chest.

Fetal Injury

According to the report, about 20% of babies born during shoulder dystocia deliveries suffer a temporary or permanent injury. The most common are:

Brachial Plexus Injury – This is damage to the nerves of the spinal cord. It can result in Erbs Palsy.
Fractured clavicle – Pressure from the delivery process causes the clavicle bone to fracture. It is considered a “safety Valve” according to the report, due to the fact that it allows the delivery to proceed.
Contusions – As the physician tries to maneuver the baby’s body through the deliver, bruises often result.
Fetal asphyxia – As delivery starts, the umbilical cord is compressed and the flow of nutrients drops quickly. The delay of the delivery puts the baby in distress. If the delivery is not completed within five-to-ten minutes, the baby may suffer brain damage or death.
Maternal Injuries – For the mother, excessive blood loss and tears to the vaginal walls are common injuries during a shoulder dystocia pregnancy.

Prevention and Diagnosis

Until recent years, preventing these deliveries was extremely difficult for physicians. However, there are now procedures and tests to detect when shoulder dystocia is likely. For example, doctors now know that the risk of shoulder dystocia is higher after one incident. Additionally, once it is detected, there are tools to assist with completing the delivery as quickly and safely as possible. However, the medical delivery team must be prepared to deal with these situations immediately. Undue delay can result in preventable injuries to the baby and mother. If a parent can prove negligence by the doctor in letting the condition occur or failing to adequately handle it, there may be a finding of malpractice and an award of damages.

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