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Is Erb’s Palsy avoidable?

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    A baby born in Gloucestershire has recently hit the headlines as he was almost twice the national average in birth weight, delivered naturally at 15lbs 7oz! The baby’s size went undiagnosed during pregnancy and caused significant problems with the delivery, as his shoulders became stuck; a life threatening situation called ‘shoulder dystocia’.

    By Kerstin Kubiak

The baby who hit the headlines became stuck, a condition termed shoulder dystocia, in the birth canal following delivery of his head by a ventouse cup. Whilst stuck the baby’s oxygen supply was severely compromised as his umbilical cord and chest became compressed. His mother described the situation as “horrifically traumatic”. It took over 5 minutes to deliver the baby’s body, by which time he was starved of oxygen and was blue and lifeless, requiring resuscitation. Amazingly, after over 4 weeks in a specialist neonatal unit in Bristol, the baby made a complete recovery and is doing very well.

Of course very few babies are born weighing a whopping 15lbs, but the occurrence of shoulder dystocia is not uncommon. It is quite often very difficult to predict the size of a baby during pregnancy and an undiagnosed large baby is also not uncommon and it can be difficult to diagnose on an ultrasound scan. The cause of shoulder dystocia is also not always clear and the baby does not have to be large for it to occur.

When shoulder dystocia does arise during delivery of a baby it is important that emergency steps are taken by the midwives and doctors to safely deliver the baby to prevent damage to the baby’s brachial plexus nerve (the nerve in the neck). If this nerve is damaged then it can cause a permanent nerve injury known as Erb’s palsy. The development of Erb’s palsy is not always as a result of negligent hospital treatment as it can be an unavoidable consequence of birth; however if medical staff fail to follow set guidance to minimise the risk of a nerve injury to the baby then it may be possible to sue the hospital for having caused the injury.

Within the clinical negligence team we have a specialist knowledge of Erb’s palsy cases and deal with an increasing number of new claims every year, a concerning trend. Much research has been undertaken into the importance of training for medical staff to ensure they are well rehearsed on the procedures required during this obstetric emergency. Research led by Professor Draycott at Southmead hospital, Bristol demonstrates clearly that good repeat training produces staff who are competent to appropriately manage shoulder dystocia birth complications, and avoiding injury to the baby’s brachial plexus nerve.

Women who suffer this complication during childbirth can often be left very traumatised. The charity ‘the birth trauma association’ support women who have suffered a traumatic experience during childbirth and work to prevent such situations occurring. In addition the charity, The Erb’s Palsy Group, who we work closely with, provide support and guidance to parents, adults and professionals affected by Erb’s Palsy. The two charities work together to support parents and comment: “The birth of a child who suffers an Erb’s Palsy has a long lasting effect, not only do parents have to deal with a lifelong disability, but the implications for having another child after the injured one, can bring great worry and distress to mothers.”

Is Erb’s Palsy avoidable? This is very much dependant on increased awareness and better training of medical staff and, with this, it is hoped that the incidence of what can be an extremely debilitating condition will be reduced. If you consider that you may have a negligence claim or wish to consider suing the NHS then it is important to consult a specialist medical negligence solicitor.

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