A term that expectant mothers and fathers may have heard is shoulder dystocia (SD). However, understanding what it is may not have been heard so much. A complication in birth when the body remains stuck behind the pelvis, it is rare and can be effectively dealt with. Here is a quick lowdown.
The basics: In normal deliveries, the body follows the head following a short delay. However, with SD this period of delay goes on for too long. As a result, the baby can be put at risk of not being able to breath; due to pressures on their body and the constriction of the umbilical cord.
Unfortunately, there is presently no way of determining the instances of a problematic birth of this nature, whilst there are factors that many believe could be contributory. Mindful of this, any professional birthing team will be aware that large babies and a diabetic mother could increase the risk. However, it is important to note that the majority of larger babies and diabetic mothers do not present any problems.
Previous episodes: There is some thought that mothers who have suffered from shoulder dystocia previously are more at risk, though research into this has largely proved inconclusive. Induced labors could also carry a higher risk but, once again, there are no significant figures that can be relied upon, with most inductions completing perfectly fine. No matter what however, all labors will be monitored carefully.
Whilst these considerations will be noted by the medical team, there still is no way of predicting what will happen through any birth. As such, prevention of the issue is not possible. In some cases where it has happened in previous births, a c-section may be advised, but are no guarantees with this either.
If an when the condition does present itself through labor, all available medical staff team members will be immediately called. Mom will be told to cease pushing, and will be repositioned lying on her back with her legs pushed down onto the abdomen. With pressure on the abdomen, baby will be worked into a better position.
On occasion, it will be necessary for the delivery area to be enlarged, through a small incision in the vaginal opening. This will remain the last option however, with all other well practiced procedures applied ahead of this action being taken.
If shoulder dystocia should happen throughout a birth, it will naturally be extremely frightening for the mother and the birthing partner. The medical team however will know exactly what to do, and have an emergency procedure in place ready to act immediately.
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Erb-Duchenne palsy is normally caused at birth and is an injury associated with the upper portion of the arm affecting the main group of nerves. The extent of the damage has a great deal to do with the type of treatment necessary for correcting it. Living with Erbs Palsy may result in temporary paralysis that can last only a few months, or require long term therapy and even surgery.
Shoulder dystocia that occurs during childbirth is generally the cause of this type of palsy. When the baby’s head is delivered, but the shoulder is not able to pass through the pelvic bone without being manipulated, shoulder dystocia can result. In most cases it becomes an emergency situation to remove the baby immediately as the umbilical cord is compressed and the situation can become fatal within five minutes.
The condition can also present in adulthood due to a serious fall. If a person falls to one side on the shoulder, head and neck stretching the nerves severely this condition results. Other possible causes are repairing a dislocated shoulder and damage due to a gunshot wound.
There are three nerves most affected which include the axillary nerve, the suprascapular nerve and the musculocutaneous nerve. Damage with respect to each nerve can be either tearing or bruising. Partial or complete paralysis is possible as a result.
The area affected is known as the Erbs Point which is named for Wilhelm Heinrich Erb a German neurologist. There are six nerves that join together at this point. Its location is just above the collar bone and includes all of the nerve fibers that run from the spine through the neck, then through the armpit and arm.
The signs associated with the condition can be anywhere from loss of sensation to complete paralysis due to weakening of specific muscles involved; deltoid, biceps and brachialis. The arm generally cannot be raised and remains in a position of hanging by the side rotated toward the front with the hand facing forward. This positioning is commonly referred to as waiters tip.
There are three common types of treatment including nerve transfers; nerves are taken from an opposite leg, latissimus dorsi tendon transfers and subscapularis releases. Due to possible nerve damage, nerve transplants are generally only done on infants that are less than nine months of age. At present age limitations are not a concern for other procedures.
External rotation is improved by tendon transfer however, due to muscle position following surgery; increased sensitivity is a very common occurrence. Range of motion can be greatly increased with subscapularis releases and this procedure can be done more than once if necessary. There is the possibility of weakening the existing muscle with the surgery being repeated.
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A lot of women over the years have been in the position of needing a caesarean section in order to deliver their baby safely. There are many factors that can be the reason for this and we will look into some important things that should be known about this kind of procedure.
One myth that many women have is that they believe that a c-section is not a major operation. This is not the case at all as it is a major form of abdominal surgery. Any of the risks that are associated with other abdominal procedures are a possibility with having a c-section performed as well.
Hemorrhaging, infections, complications due to the anesthetic, are all very real things that could result from having this kind of an operation. There are a lot of other potential problems as well, but these are among the most common ones that we see.
There are a variety of reasons for this operation to be necessary, such as of the positioning of the baby inside the uterus. It is very common for a doctor to advise women that have a baby that is in the breech position to undergo this type of delivery to ensure both the health of the baby and the mother are not put at unnecessary risk.
Women that have some certain diseases or infections also may need to have this kind of procedure. The reason being that the doctor will want to prevent the condition the mother has from being passed on to the baby when it is being delivered.
In the past it was normal for women that had one c-section to continue to have the same procedure for any births that they had. Now this is not something that has to be done. With the way that doctors have changed the surgical incisions that are mad for caesarean births they can now allow a woman the opportunity to de3liver a child naturally if that is what they want to do.
The internet has a great deal of information about caesarean section procedures. Reading through some of the information that you find can help you learn the information that you should be aware of before having this done. You should also be sure to ask any questions that you may have to the doctor that will be doing the operation as this can also help alleviate any fears that you may have.
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