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Causes of Erb's Palsy
If your child suffers from Erb’s Palsy, you should
consider the possibility that your doctor or medical care
professional may not have done all that is possible to
prevent Erb's Palsy during childbirth. The experienced birth
injury attorneys of Oshman & Mirisola, LLP are always
available to speak with you, and if you are unable to come
to our offices for an initial case sign-up, we will send
someone to you whether at home or in the hospital.
What causes Erb’s Palsy?
Occasionally during labor and birth, a baby's shoulder can
get stuck on the mother's pelvic bone. This birthing
emergency is called Shoulder Dystocia. Accepted medical
protocol exists to deal with this birthing emergency.
Doctors may use many different procedures to dislodge the
baby's shoulder so that the baby can safely pass through the
birthing canal. In some cases, the doctor can reposition the
mother, or the doctor can use his or her hands to maneuver
and change the position of the baby. In particularly
dangerous and difficult births, the doctor can break the
baby's clavicle bone on purpose, break the mother's pelvic
bone or perform an emergency C-section. A doctor can cut a
deep episiotomy, perform the McRobert's maneuver, and exert
suprapubic pressure. The doctor can also use gentle traction
in a horizontal plane to avoid damaging the brachial plexus.
In the event of shoulder dystocia, the doctor can support
the head of the baby and apply a small amount of traction
during the dislodging maneuvers. When the doctor uses
excessive traction on the head while the baby's shoulder
remains stuck, the brachial plexus nerves in the baby's neck
may suffer injury. Depending on its location, this injury
then causes one of the four types of brachial plexus palsy.
Though doctors cannot predict shoulder dystocia and the
danger of brachial plexus palsy, certain factors may suggest
that certain births face a higher risk of shoulder dystocia.
These risk factors include:
- Fetal macrosomia, which is a condition in which the pre-birth weight of the baby is over 8 lbs. 14 oz.
- Maternal diabetes
- Maternal obesity
- Short maternal stature
- Platypelliod, or contracted or flat pelvis
- Maternal weight gain of 35 lbs. or more
- Additionally, a protracted first stage of labor may suggest an increased risk for shoulder dystocia and consequently, increased risk for brachial plexus palsy. In addition, a breech birth or other abnormal presentation of a fetus, while not a risk for shoulder dystocia, can result in brachial plexus injury.
The use of tools, including forceps or vacuum, to help
the baby descend, may increase the risk of shoulder dystocia
as well. Studies also suggest an association between an
increased risk for shoulder dystocia and the use of
labor-inducing drugs.
Despite these risk factors, more women have uneventful
birthing experiences than those whose labors are complicated
by shoulder dystocia. In addition, shoulder dystocia can
occur in the absence of these risk factors as well. A
minority of obstetric brachial plexus impairments are not
related to shoulder dystocia. Some other reasons for this
disability include tumors in the baby's neck or the mother's
uterus, viral disease or other abnormalities.
Most brachial plexus injuries are usually mild and most will
recover in 3 to 4 months. The more severe injuries may take
18 to 24 months to recover. During this recovery time
physical therapy may be necessary. Gentle range of motion
exercises and electrical stimulation of muscles need to be
performed regularly to keep the joints of the arm supple and
prevent atrophy.
If you feel your child suffers from a brachial plexus injury
such as Erb's Palsy due to the negligence of your doctor or
medical professional, please contact the attorneys of Oshman
& Mirisola, LLP. You deserver to be compensated for your
child’s physical and emotional damages. Contact us today at
1-800-400-8182, or contact us online for a
free case evaluation.