Can shoulder dystocia cause hypoxic-ischemic encephalopathy (HIE)?

Yes, shoulder dystocia can cause hypoxic-ischemic encephalopathy (HIE), a permanent brain injury. HIE occurs when babies don’t get enough oxygen for too long during or around the time of labor and delivery. The chance of a severe brain injury increases the longer a baby goes without oxygen. Brain injuries like HIE can cause lifelong disability, such as cerebral palsy, vision or hearing problems, or intellectual and developmental disabilities.

If medical staff do not perform a C-section to avoid shoulder dystocia, or they mismanage shoulder dystocia during labor and delivery, they can put the baby at risk of further complications and injury. It’s critical that  a baby with shoulder dystocia is delivered safely and promptly so they do not suffer from oxygen deprivation and HIE.


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What is shoulder dystocia?

Shoulder dystocia occurs when a baby’s shoulders get stuck inside the pelvis during labor and delivery. It is an emergency condition because it can put the baby at risk of injury, including not getting enough oxygen.

Shoulder Dystocia and Brachial Plexus Injury

When shoulder dystocia occurs, the baby may not be delivered quickly enough. Shoulder dystocia is associated with many factors, including prolonged labor, which is traumatic for the baby. Babies can suffer from oxygen deprivation and HIE if they endure labor for too long or get stuck for too long. 

If labor is prolonged or other risk factors are present, the doctor may determine a C-section is the safest way to deliver the baby. This can help prevent shoulder dystocia. 

Shoulder dystocia risk factors and complications

Shoulder dystocia can occur in any pregnancy, and it cannot always be prevented or predicted. However, the following are notable risk factors:

  • Cephalopelvic disproportion: A labor complication where there is a size mismatch between the mother’s pelvis and the baby’s head.
  • Fetal macrosomia: A condition where the unborn baby is abnormally large.
  • Diabetes or gestational diabetes: These conditions can be associated with fetal macrosomia.
  • The baby is not in the correct position.
  • Shoulder dystocia occurred in a previous pregnancy.
  • Pregnancy with twins or multiples.

If these risk factors are present, physicians must take the proper precautions to safely manage the pregnancy and ensure a safe delivery. If physicians fail to manage these risk factors, they can cause complications that lead to HIE and brachial plexus injuries, including Erb’s palsy.

Other associated labor and delivery complications can also lead to shoulder dystocia and hypoxic-ischemic encephalopathy (HIE) if managed incorrectly.


Did you experience complications during your labor? If you suffered from labor complications that caused injury to your baby, you have options. Our birth injury team is here to help.


Vacuum extraction delivery and shoulder dystocia

In a rush to deliver the baby, some physicians may use risky delivery methods, such as a vacuum extraction delivery. The use of a delivery instrument such as a vacuum extractor significantly increases the risk of shoulder dystocia.

A vacuum extractor has a cup that is applied to the baby’s head. The physician uses the vacuum extractor to apply gentle suction to the baby’s head to help move the baby out of the birth canal.

A vacuum extractor does not shift the baby’s position in the birth canal so that the shoulders are at the correct angle for passage through the birth canal. Instead, a vacuum extractor interferes with the delivery process by pulling the baby straight down. This method prevents any rotation of the shoulders into the correct angled position, pulling the shoulders into the top of the pelvis and causing the baby to get stuck. 

Delivery instruments like vacuum extractors should not be used when:

  • Shoulder dystocia is present
  • The baby is too large 
  • Mom is diagnosed with cephalopelvic disproportion (CPD)

Umbilical cord problems and shoulder dystocia

Shoulder dystocia is also associated with umbilical cord problems, such as a compressed umbilical cord. The umbilical cord is the baby’s lifeline; it delivers oxygen to the baby. Anything that disrupts the flow of oxygen through the cord can cause the baby to suffer from HIE. 

When shoulder dystocia occurs, the umbilical cord can get trapped between the baby’s arm and the mother’s pelvic bone. This is a very serious problem, and the baby must be delivered immediately, usually via emergency C-section if delivery maneuvers don’t work.

Labor drugs and shoulder dystocia

Another risky method that physicians may turn to when shoulder dystocia occurs is inducing labor with Pitocin or Cytotec. These drugs can cause uterine tachysystole. This means the contractions become so strong and frequent that the uterus is in a constant state of contraction. 

When the uterus is constantly contracting, blood vessels in the placenta that carry blood and oxygen to the baby can become compressed. This compression prevents blood flow to the baby. If the decreased blood flow is severe enough or lasts long, the baby can become severely oxygen-deprived and become diagnosed with HIE.

Should I seek legal help for my child’s shoulder dystocia injury?

Childbirth can unfortunately be traumatic for many parents due to complications such as shoulder dystocia. A time of joy can quickly turn into anxiety when your baby is injured. It can be doubly overwhelming to discover that your child’s injury could have been prevented. If your child had complications from shoulder dystocia that led to permanent injury, consulting with a skilled birth injury lawyer can provide you with answers and options that may help your child.

If you are considering legal help for a birth injury from shoulder dystocia, it is very important to choose a lawyer and firm that focuses only on this type of medical malpractice law. A firm that focuses on birth injury cases will be equipped with the correct resources, knowledge, and experience to help parents like yourself during this challenging time. 

At ABC Law Centers, we have extensive experience handling birth injury cases involving shoulder dystocia and hypoxic-ischemic encephalopathy (HIE). Our firm’s attorneys give personal attention to each child and family they assist. We are privileged to help families like yours secure lifetime care for their children, including but not limited to:

  • Finances to help pay for your child’s medical care, even after you are gone
  • Alternative and complementary therapies for your child
  • Adaptive tools and equipment to help your child live as independently as possible

For over 25 years, our firm has been proudly advocating for children like yours and obtaining justice on their behalf. Our staff understands the hesitations and worries that some parents may have when it comes to pursuing a lawsuit. That’s why we listen to you attentively, investigate where malpractice may have occurred, and discuss your options with you. Our staff is happy to provide you with the information you need to make the best decision for your child and family. 


We are here for you whenever you’re ready.

You can reach us by email, text, or phone call, at a time convenient for you.



Related Resources:

Sources

  1. Shoulder Dystocia: Signs, Causes, Prevention & Complications
  2. Shoulder Dystocia: Managing an Obstetric Emergency | AAFP
  3. Shoulder dystocia: an Evidence-Based approach – PMC
  4. Shoulder dystocia: Risk factors and planning birth of high-risk pregnancies – UpToDate