Shoulder Dystocia

on Mar 23, 2020

This case involved a difficult delivery where the baby’s shoulder become lodged in the mother’s pelvis resulting in injury to the nerves that extend down through the shoulder into the baby’s arm. It was claimed that the actions of the doctor caused the nerve injury during an attempt to dislodge the shoulder. Trial Exhibits was called upon to show that the injury occurred as the result of the natural forces of labor and that the doctor never applied any traction or pulling force while performing the maneuvers to dislodge the shoulder.

The Trial Exhibits solution was to create a custom medical animation demonstrating the key steps of the shoulder dystocia and the maneuvers employed to release the shoulder. First, we showed how the maternal forces of contractions and maternal pushing advance the baby down into the birth canal. Next, we showed how a combination of these forces with the impaction of the shoulder caused the stretching of the nerves of the brachial plexus.

Finally, we animated the maneuvers employed by the doctor to release the shoulder. This included the episiotomy to open up the vaginal outlet, the insertion of the doctor’s hand to confirm that the shoulder was lodged behind the mother’s pelvis, the elevation of the mother’s legs into the McRoberts position, the application of suprapubic pressure, and the administration of the rotational maneuver to release the shoulder.

At the conclusion of the animation, it is clear that the final delivery was facilitated by the maternal forces of contractions and maternal pushing. Although the doctor was able to dislodge the shoulder utilizing a variety of maneuvers, no traction or pulling forces were ever employed.

Click here to view the video on our YouTube page