Shoulder Dystocia and Brachial Plexus Injuries During Childbirth

Shoulder Dystocia and Bra…

Brachial plexus injuries are a common complication that can arise when a baby suffers from shoulder dystocia during childbirth. In many cases, brachial plexus injuries resolve on their own. But if your child suffers from a brachial plexus injury that has not resolved, you may be entitled to compensation. An Ohio medical malpractice attorney at Robenalt Law can help by reviewing your case, and giving you advice on how to proceed.

What Is Shoulder Dystocia?

Shoulder dystocia occurs when the baby’s shoulders become stuck in the mother’s pelvis during delivery. If the mother is at an increased risk for shoulder dystocia during childbirth, the obstetrician should advise the mother of the potential risks before labor begins. This conversation should include a discussion of the risk of temporary or permanent brachial plexus injury that could occur during a vaginal delivery, and a discussion of a Cesarean section as an option.

What Is a Brachial Plexus Injury?

Brachial plexus injuries occur when there is trauma to the nerves that provide feeling and muscle control in the shoulder, arm, forearm, hand, and fingers. They are common during childbirth, especially if the baby is breech (bottom-first), the mother has a long labor, or if the baby’s shoulders are too wide to fit through the birth canal.

When maternal forces increase the angle between the neck and shoulders, the brachial plexus nerves may stretch or even tear, resulting in damaged nerves that carry sensation poorly and weaken muscle movements.

How Do Brachial Plexus Injuries Occur During Childbirth?

The most common cause of brachial plexus injuries during childbirth is shoulder dystocia, which occurs when the baby’s shoulders become stuck in the mother’s pelvis. A baby that experiences shoulder dystocia during childbirth is more susceptible to brachial plexus injuries when a physician applies lateral traction - an upward or downward rotational pulling force applied to the baby’s head that is often used to try to dislodge the baby. Permanent brachial plexus injuries may result when a physician applies lateral traction forces during a shoulder dystocia.

Shoulder dystocia can be diagnosed during delivery when the baby’s shoulders fail to deliver shortly after the head, indicating that the baby’s shoulders are stuck. If the doctor pulls too hard on the baby’s head, the baby’s shoulders and the brachial plexus nerves can be strained or damaged, resulting in brachial plexus injury.

Factors that can contribute to increased risk of brachial plexus injuries include:

  • Unusually long or short second stage labor
  • Maternal obesity
  • Induced labor
  • Abnormal cervical dilation
  • The use of vacuum extractors or forceps
  • Administration of Pitocin during labor
  • Prior deliveries that resulted in brachial plexus injuries

The risk of brachial plexus injury increases when vacuum extractors or forceps are used because these tools increase the risk of a physician applying too much force to the baby’s head, straining the baby’s shoulders.

During delivery, the physician should use gentle traction. Anything more than gentle traction can result in injury to the brachial plexus. If dystocia does occur, the doctor should use gentle maneuvers to deliver the baby while preventing injury to the brachial plexus. In some cases, if risk factors for shoulder dystocia and brachial plexus injuries are high, delivery via C-section is safer.

In the last 20 years, medical malpractice defense attorneys have argued in medical malpractice lawsuits that brachial plexus injuries may be the result of maternal or natural forces of labor and delivery. This hypothesis, however, is unscientific and critically flawed because maternal forces rarely cause permanent brachial plexus injuries. In fact, it is almost impossible for the mother to stretch the fetal brachial plexus nerves to the point where permanent injury would result.

How Do I Know if My Baby Suffers from Brachial Plexus Injury?

Signs and symptoms of a brachial plexus injury in newborns include:

  • Lack of full movement in the arm
  • Weak grip strength
  • Numbness or tingling
  • Holding the arm in an odd position

These conditions may be observed in newborns or infants that cannot lift their arm above their head, have difficulty moving their fingers, or cannot bring objects to their mouth.

Brachial Plexus Injuries and Erb’s Palsy

Severe cases of brachial plexus injury are referred to as Erb’s palsy, named for the physician that published a thesis in 1874 that identified the root cause of the condition. When an infant suffers from Erb’s palsy, the condition can be treated with home physical therapy starting as early as 3 weeks old. These exercises will prevent stiffness, atrophy, and shoulder dislocation.

What Should I Do If My Child Suffers from Brachial Plexus Injury?

Brachial plexus injuries occur in 2 to 3 births out of every 1,000. In many cases the injury is not permanent and the child will regain strength and feeling in the affected arm without treatment.

Sometimes the baby may require assistance from the parents through daily physical therapy exercises. For more severe cases, a child may need intervention from specialists including:

  • Neurologists
  • Neurosurgeons
  • Physical therapists
  • Occupational therapists

In severe cases when surgery is required, a doctor may recommend nerve grafts, nerve transfers, muscle transfers, or tendon transfers. It may take up to 8 months after surgery for nerve function to show.

Robenalt Law Fights for Victims of Medical Malpractice

If your child suffers from a brachial plexus injury or Erb’s palsy, you may be entitled to compensation including:

  • Costs of past and future medical treatment
  • Emotional trauma
  • Lost wages
  • Pain and suffering
  • Punitive damages

Contact the experienced Ohio medical malpractice attorneys at Robenalt Law today for answers. Our lawyers fight for people who have been victims of medical malpractice. Call us at 216-233-7573, email trobenalt@robenaltlaw.com, or complete our online form.

Tom Robenalt started his litigation career representing doctors and hospitals at a large firm in Cleveland. For the past 25 years, he has used that experience to help victims and the families of those injured by negligent health care providers.

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