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The occurrence of brachial plexus injury during delivery

New Mexico parents may know that some risk is a part of childbirth, but there are ways to lessen the risk and deal with emergencies. When a child is delivered, the infant's shoulders lie at an angle to the pubic bones. However, the shoulders may become stuck behind the bone. If a physician or midwife pulls downward with force, the plexus of nerves between the spine and shoulder may be stretched or torn. The stronger the applied force, the greater the nerve damage.

There are specific risk factors that can lead to shoulder dystocia. They relate to the baby's size, gestational weight gain by the mother, a small pelvis, prior dystocia or brachial plexus injury and slow onset of cervical dilation. Appreciation of the risk factors may prevent shoulder dystocia by circumventing a vaginal birth. Monitoring the mother's weight and evaluating gestational diabetes are important as is evaluating pelvic size in the first prenatal visit.

When dilatation and descent is slow, a doctor needs to think if the fit is tight and may prevent normal delivery. Using forceps or a vacuum extractor may accentuate the problem. A C-section may be the best alternative. In addition, there are maneuvers to assist in delivery, although pulling down on an infant's head is contraindicated. If a doctor fails to evaluate whether vaginal delivery is appropriate or causes birth injury during delivery, the child may face brachial plexus injury. This may require ongoing care or surgery with a resultant financial burden. The parents may decide to seek compensation.

An attorney may help parents in a similar situation by evaluating prenatal care and procedures used during delivery to determine negligence. If expert opinion opines that the doctor failed to provide the standard of care, the attorney may file a malpractice suit to recover damages.

Source: BirthInjury.org, "How Brachial Plexus Injuries Occur", October 16, 2014

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