Induced Labor Might Help Prevent Brachial Plexus Injury in Babies

 The results of a new study show that in the case of pregnant women who are obese, elective induction of labor at 39 to 41 weeks of gestation may be a far better choice in order to prevent a difficult labor and delivery. The study, done by researchers at the Rollins School of Public Health in Emory University, Georgia, was published Dec. 4 in the journal Obstetrics & Gynecology.

Details of the Study
Maternal obesity, defined as a pre-pregnancy body mass index (BMI) of 30 or more has been associated with an increased risk during labor and delivery of conditions such as preeclampsia (high blood pressure), shoulder dystocia (where infant’s shoulder gets stuck in the mother’s pelvic bone) and brachial plexus injury or Erb’s palsy where the nerves in the child’s neck, shoulder and arms are stretched and/or torn during birth.
Researchers determined that the likelihood of a difficult labor and delivery that may lead to Erb’s palsy increases with the woman’s age. So, for obese mothers, inducing labor may prevent the likelihood of a brachial plexus injury or Erb’s palsy. For this study, researchers used data from the 2007 to 2011 California Linked Patient Discharge Data-Birth Cohort File, which includes information on more than 95 percent of childbirths to California residents.
Larger Babies Problematic As Well
Erb’s palsy or brachial plexus injury is caused by damage to nerves in the neck during birth. This might cause the child to have problems using his or her arm. The damage or disability may become permanent. In many cases, the child’s arm may become permanently paralyzed.
While multiple studies have shown obese mothers’ children are more at risk for Erb’s palsy, there is evidence that indicates a larger than average baby may also be at risk. One of the biggest issues in such cases is difficulty with delivering the shoulders after the baby’s head has come out. Erb’s palsy or brachial plexus injuries are the most common consequences in cases where the baby gets stuck in the birth canal during labor and delivery.
The term “fetal macrosomia” is used to describe a newborn that is significantly larger than average. Such an infant has a birth weight of more than 8 pounds, 13 ounces regardless of his or her gestational age. About 9 percent of babies born worldwide exceed this birth weight. However, the risks associated with larger babies increase significantly when the baby’s birth weight is over 9 pounds 15 ounces. A bigger baby tends to complicate vaginal delivery and may put the baby at risk of injury during birth.
Steps That Can Be Taken
There are a few steps that can be taken in order to prevent Erb’s palsy especially when it is known that you or your child are at risk, such as:
• Cesarean delivery: This is often a good alternative to normal vaginal delivery in high-risk cases because the fetus is allowed to bypass the mother’s pelvis. Therefore, with a C-section, the child is protected from the excessive force of labor that might result in a brachial plexus injury. Some studies have demonstrated that brachial plexus injuries can be reduced by cesarean delivery.
• Care during breech delivery: Extreme care should be taken during breech deliveries (where the baby is delivered feet-first instead of head-first). This is especially true in the case of premature babies who are at a higher risk of sustaining brachial plexus injuries or Erb’s palsy.
• Interventions: Preliminary intervention for shoulder dystocia in a patient with known risk factors involves implementing the head and shoulder maneuver to deliver through until the anterior shoulder becomes visible. This can be accomplished by continuing the momentum of the fetal head delivery until the shoulder comes in view. Once controlled delivery of the head is achieved, the obstetrician proceeds with immediate delivery of the anterior shoulder.
• Care with birthing tools: Obstetricians must be skilled and careful while using tools such as vacuum extractors and forceps to get a baby that is stuck in the birth canal out. Applying excessive force is one of the common causes of Erb’s palsy.
If Your Child Has Been Injured
If your child has suffered Erb’s palsy or a brachial plexus injury as a result of medical negligence, the experienced New York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you. One of our clients secured a $2,850,000 verdict that was reduced by the appeals court to $1,850,000 because the verdict was so large. This was the highest amount upheld by the appellate courts for many, many years. In addition we recovered $1,400,000 for a newborn who lost motion in the arm during birth due to doctors applying incorrect force on the baby’s head.
Please contact us TOLL FREE 24 hours a day, 7 days a week at 1-800-WORK-4-YOU (1-800-967-5496). WE CAN EVEN COME TO YOU. There is no attorneys’ fee unless we recover money for you. We can also help with personal injury cases in New York, New Jersey, Connecticut, Pennsylvania, or Florida. If you have been seriously injured in any of the 50 U.S. states, please call us and we will try to help you with your case.
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Source: https://www.medscape.com/viewarticle/889997#vp_2