Fetal Macrosomia

Birth Injury--Failure to Recognize the Oversize of the Fetus

Most babies are delivered in a hospital in close proximity to the mother’s attending obstetrician. In some cases, mothers have special medical circumstances that require specialized training in obstetrics. A minority of babies are delivered by midwives rather than physicians.

Unfortunately, some babies are injured before or during the delivery process. According to the Center of Disease Control (CDC) six out of every 1,000 births in America result in an injured child. The injuries a newborn are wide-ranging. The injuries can be life threatening and life changing, from a shoulder injury such as a brachial plexus to a devastatingly terrible brain injury leading to a child with cerebral palsy.

Many of the birth injuries that occur are preventable and avoidable. The physiological makeup of a mother for example, a smaller pelvis is known in advance. The fact that a unborn baby is large would make it very difficult, if not impossible, to deliver this child vaginally with the mother’s physical makeup includes a narrow pelvis.

In a case where a large baby is attempted to be delivered, the delayed delivery may cause oxygen deprivation which can lead to serious and permanent brain injury to the child. Intrapartum oxygen deprivation is referred to as neonatal hypoxic ischemic encephalopathy (HIE). This arises when the unborn baby receives less than the required amount of oxygen because of an interruption of oxygen flow which can happen if the placenta becomes partially detached from the wall of the uterus; a placental abruption.. The result is a hypoxic injury. In too many of these cases, the birth injury is caused by the negligence of a doctor, nurse, midwife or other medical provider. Most birth injuries are caused by mistakes during labor and delivery that include the failure to recognize and act on fetal distress.

Fetal distress may be indicated objectively by electronic fetal monitoring which should be ongoing when the mother arrives in labor. Another birth injury mistake is the incorrect use of forceps. The incorrect use of forceps and using excessive force is a common cause of birth injuries. In every case where the fetus is in distress and/or there is a preventable cause of oxygen deprivation, the unborn child is in great danger of severe and permanent brain injury. Sometimes the mistakes are in application of medication to the mother or the use of dangerous medication that caused injury to both the mother and the unborn child.

In too many of the birth injury cases, the medical errors seem to be progressive in that one error compounds another. Many times the immediate need for Cesarean section delivery is overlooked causing what amounts to preventable and avoidable brain injury to the child.

When the infants estimated weight is greater than 90% of the average weight of babies at or about the same gestational age, that baby is considered macrosomia and puts the mother and unborn child at a high-risk. Most physicians would consider macrosomia when the baby has a weight in excess of 9 pounds, 15 ounces. Over 10% of all pregnancies in the U.S. result in macrosomia according to the American Academy of Pediatrics. In a case of macrosomia, vaginal delivery may be contraindicated and dangerous.

The diagnosis of fetal macrosomia is imperative. Signs and symptoms of this condition, that is an unusually large fetus, include the finding of excessive abdominal fluid or amniotic fluid that can be identified by ultrasound. Large babies tend to urinate more than normal sized babies and that result in an excess amount of amniotic fluid.

Another sign or symptom of fetal macrosomia is the distance from the uterus to the mother’s pelvic bone. This is called the fundal height. This measurement will reveal the size of the unborn baby.

The dangers of fetal macrosomia include the high risk of complications when the mother goes into labor. One of the major risks is that the large baby will become stuck in the birth canal giving rise to the emergent need to use birth-assisting tools to help with the delivery. But too often the baby is at risk of brain injury because of the difficulty in delivery. There are also the dangers of shoulder dystocia or nerve damage, oxygen deprivation or hypoxia causing severe and permanent brain damage to the baby. To be safe to the mother and baby, fetal macrosomia can be handled by prearranging a Cesarean section at full-term.

For more than 40 years, Kreisman Law Offices has been handling birth injury cases on behalf of those injured. If you or someone you know has a child or infant who has been injured by a delayed delivery of fetal macrosomia baby, please feel free to call our experienced lawyers at Kreisman Law Offices.

With more than 40 years of experience in trying and settling birth injury cases, Kreisman Law Offices provides the best possible services to our clients and have achieved unsurpassed results. Our service is unmatched. Please call us 24 hours a day at 312.346.0045 or toll free 800.583.8002 for a free and immediate consultation, or complete a contact form online. There is no charge for a consultation that will include an evaluation of your case.

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