Shoulder dystocia can be a very serious condition and can affect a child throughout his or her lifetime.  There are occasions in which this injury could have been prevented and this can give rise to a child birth injury medical malpractice lawsuit.

Shoulder dystocia is a case of dystocia wherein the anterior shoulder of the newborn can’t pass the pubic symphysis after the delivery of the head, or needs considerable manipulation to pass the pubic symphysis. Shoulder dystocia is diagnosed only when the shoulders of the infant fail to deliver after the fetal head. In this condition, the chin presses against the perineum walls.

Signs of Shoulder Dystocia

Turtle sign is a commonly described feature, characterized by the appearance and retraction of fetal head that resembles a turtle withdrawing into the shell. The red puffy face indicating facial flushing is also a sign of this condition. This happens when the shoulder of the baby is stopped by maternal pelvis.

Procedures of Shoulder Dystocia

Several obstetrical measures are adopted in order to facilitate the delivery when this condition occurs:

  • Suprapubic pressure
  • McRoberts maneuver
  • Application of pressure on the anterior shoulder, bringing the fetus in an oblique position with head towards vagina (also called the Rubin II maneuver)
  • Wood’s screw maneuver (also called the opposite of Rubin II maneuver), causing the anterior shoulder to turn to the posterior and vice versa
  • Barnum’s maneuver (also called Jacquemier’s maneuver, allowing the delivery of the posterior shoulder first; this enables the forearm and hand to be identified and pulled gently.
  • Gaskin maneuver, involving the movement of the mother to all-fours position, causing the pelvic outlet to widen (named after Ina May Gaskin, Certified Professional Midwife)

Some measures are even more drastic; these include:

  • Zavanelli’s maneuver; the fetal head is pushed back in by performing a cesarean section
  • Intentional clavicular fracture, reducing the shoulder diameter and allowing it to pass across the birth canal
  • Symphysiotomy, making the birth canal opening laxer by breaking the tissue between the pubes bones, allowing the shoulders to pass through.
  • Hysterotomy that allows the delivery of the obstructed shoulder

Management of Shoulder Dystocia

For most obstetrical nursing units in North America, management of shoulder dystocia has now become a focus point. Various courses are offered to nurses wherein they perform routine drills to prevent any delivery complications for both mother and fetus.

ALARMER for Shoulder Dystocia

This is a common treatment algorithm used in most health care facilities:

  • A – ask for help
  • L – leg hyperflexion
  • A – anterior shoulder disimpaction
  • R – rubin maneuver
  • M – manual delivery of posterior arm
  • E – episiotomy
  • R – roll over on all fours

Complications of Shoulder Dystocia

The prime concern of shoulder dystocia is the upper brachial plexus nerves damage. Excess tension can tear the nerve roots, resulting in complete dysfunction of the fetus. The ventral roots are at greatest risk of injury as these endure the greatest tension.

Contact a Michigan Shoulder Dystocia Malpractice Lawyer

If an infant suffers shoulder dystocia due to medical negligence, it can give rise to a medical malpractice lawsuit.  Shoulder dystocia may affect a child socially, academically, and vocationally throughout childhood and even into adulthood.  The child may require physical therapy, medical procedures, and other services that can be a significant expense over the course of his or her lifetime.  These types of damage requests are included in a medical malpractice lawsuit filed for the condition of shoulder dystocia.

There are strict time delays for filing birth injury lawsuit so it is essential to contact an experienced lawyer as soon as possible to see if your child has valid case.

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