Forceps delivery blamed for cerebral palsy

November 1, 2010

Since a Wisconsin woman's pregnancy in 2004, she was cared for by a group of obstetricians until March 2005, when she switched doctors. In April she was admitted to the hospital near-term with pre-eclampsia.

Spontaneous rupture of membranes occurred 2 days later, and she was transferred to labor and delivery. At that time, she was placed on magnesium sulfate for preeclampsia and oxytocin induction was started. The woman made very slow progress, but eventually she became completely dilated and began pushing.

Fetal heart rate monitoring showed late decelerations, and the attending obstetrician, who arrived about 30 minutes later, decided that the woman could be delivered using forceps. The resident applied the forceps, which slipped off several times, and the attending attempted to reapply them twice more. The resident then used a vacuum to deliver the head. A shoulder dystocia was encountered, and the attending took over the delivery. The infant had a cord blood pH of 6.96 and a base deficit of –17.3 and was found to have several skull fractures.

The physician claimed that skull fracture could occur in normal spontaneous delivery and that because the child's cerebral palsy was not spastic quadriplegia, the injury was likely because of a sinus venous thrombosis. The parents countered that the child had never had a sinus venous thrombosis, and a jury returned a $23.2 million verdict against the attending obstetrician and the compensation fund only, to which the court added $187,402 as agreed-upon medical expenses.

Ms Collins is an attorney specializing in medical malpractice in Long Beach, California. Send your feedback about this column to contemporaryobgyn_advanstar_com