A new study reviews the advantages of inducing labor in pregnancies with a larger than normal fetus.
A new study reports that inducing labor for pregnancies with large babies may decrease the risk of shoulder dystocia. If these findings are supported, pregnant women and their medical providers may be able to proactively reduce the risk of certain birth injuries.
More on shoulder dystocia
Shoulder dystocia is a birth injury that generally occurs when one or both shoulders of the infant become stuck behind the mother’s pelvis during delivery. Fetuses that are larger than usual have an increased risk of suffering from this form of birth injury than those that measure at normal or smaller sizes. Additional contributing factors can include a small maternal pelvis, the presence of multiple infants within the womb, maternal obesity or diabetes and delivering the infant past the due date.
Both mother and infant can suffer injuries connected to shoulder dystocia. The infant can experience a lack of oxygen, broken collarbone and nerve damage to the shoulder, arm or hand while the mother can experience uterine rupture or hemorrhaging. In some cases, severe injuries to the infant can lead to brain damage or the development of Erb’s palsy.
Erb’s palsy and shoulder dystocia
Erb’s palsy is an injury that occurs when the nerve’s within the infant’s spinal cord and arms are injured. It can lead to permanent paralysis. The American Academy of Orthopaedic Surgeons note that the damaged nerves have an impact on arm growth, as a result infants that suffer from this injury may have one arm that is noticeably smaller than the other. This difference can become more apparent as the child grows.
More on the study
In an effort to reduce the risk of these injuries, a study conducted out of Europe pooled a group of pregnant mothers who were at high risk of shoulder dystocia due to the large size of their fetus to volunteer for a study. Approximately half of the women were randomly chosen for induction of labor at 37 to 38 weeks while the others were closely monitored. Of the 413 women who were monitored and not part of the induction group, 116 required induction due to medical reasons. An additional 366 were induced within the induction group.
Researchers found that 2 percent of infants within the induction group suffered from injuries connected to delayed delivery, while 6 percent of those within the group assigned to monitoring experienced similar issues.
An article in Reuters reports that an obstetrician from Oregon Health and Science University in Portland wrote an editorial accompanying the study, ultimately calling for clinicians to carefully balance the risks associated with delivery before 39 weeks of gestation, like immature lungs, with the benefits of potentially avoiding shoulder dystocia.
Impact of the study
The study provides support for discussing induction of labor in instances when an infant is developing larger than usual. This study is an example of the types of innovations in the practice of medicine that physicians and other medical professionals are expected to be aware of when guiding their patients through these and similar medical decisions. Physicians that do not stay current with the changing medical landscape could put themselves at risk of unnecessarily injuring a patient.
Patients that believe they were injured by a negligent physician may be eligible for a medical malpractice suit. Contact an experienced medical malpractice and personal injury law firm to discuss your legal options.
Keywords: personal injury medical malpractice birth injury
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