Vacuum-Assisted Delivery Birth Injury
Vacuum-assisted delivery is sometimes necessary when complications arise during vaginal delivery. Doctors may use a delivery assistance tool if the mother’s pushing is not enough for the baby to travel entirely through the birth canal.
Doctors only use vacuum-assisted deliveries in certain circumstances since they increase the risk of birth injuries. When the delivery goes wrong, the baby may suffer complications that range from mild to severe.
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What Is Vacuum-Assisted Delivery?
In vacuum-assisted vaginal delivery, also known as operative vaginal delivery, the doctor will use an assistive device to remove the baby from the birth canal. These devices are typically vacuum extractors or vacuum pumps with a soft suction cup to gently extract the baby’s head.
Data shows that vacuum delivery occurs in 1 out of 20 live births, roughly 5%. It is now more commonly practiced by doctors to use vacuum pumps with soft cups instead of forceps delivery. Forceps delivery practices have been associated with more severe complications than vacuum extraction.
Vacuum deliveries are only recommended during the second stage of labor when the mother is actively pushing. Doctors will attach the soft suction cup of the vacuum pump to the fetal head and use that device to pull the baby’s head through the vaginal opening.
When Is Vacuum Extraction Deemed Necessary?
Because of the risks associated with vacuum extraction, doctors do not practice this method unless specific criteria are met. There are a few different situations where assisted delivery is necessary for the extraction of the baby.
- Prolonged Labor- When the mother is actively pushing for roughly 2-3 hours without any progress
- Fetal Distress- When the baby indicates markers of fetal distress, such as an abnormal heart rate, a vacuum pump will work quicker than a C-section
- Exhaustion- When the mother has become physically exhausted and can no longer actively push
- Maternal Health Concerns- When the mother has a pre-existing health condition that prevents her from pushing for too long
It is important to note that although these conditions may be met, professional medical advice may still indicate that an emergency Cesarean delivery may be the safest birthing method.
A C-section is when the doctor will cut a surgical incision in the mother’s uterus and abdomen to remove the baby.
How Vacuum-Assisted Deliveries Can Go Wrong
Like any other medical procedure, there are risks associated with vacuum deliveries. When doctors use a vacuum device to remove the baby, they may cause birth injuries.
Vacuum extraction injuries can be caused by many issues, such as:
- Incorrect placement of the suction cup on the baby’s head
- Wrong size or type of vacuum cup
- Too much twisting of the baby’s head and neck
- Excessive force while pulling the baby’s head
- Pulling the head in the wrong direction
- Waiting too long to recommend a C-section
When doctors have chosen operative vaginal deliveries, they need to be able to act quickly to provide prompt treatment for any issues or developments that can occur. They may even need to abandon the vacuum extraction approach and opt for an emergency C-section to put the mother and baby at a decreased risk for complications.
Common Birth Injuries Caused by Vacuum-Assisted Delivery
By using a vacuum extractor to remove the baby from the birth canal, doctors can cause birth injuries that range from mild to severe. Some of these injuries may even be life-threatening or lifelong if they are not treated immediately after vacuum delivery.
When doctors use any vacuum devices during the birth of a baby, the baby will be put at a higher risk for these common complications and birth injuries.
Brachial Plexus Injuries
The brachial plexus, the network of nerves in the shoulders, arms, and hands, can be injured during a vacuum extraction. If these areas are pulled too hard, stretched, or compressed by the vacuum tools, they can suffer mild to severe pain.
Erb’s palsy and shoulder dystocia are two of the most common brachial plexus injuries that occur to full-term newborn infants at birth. These injuries cause symptoms, including weakness, inability to move the shoulders or arms, burning sensations, neck pain, and arm numbness.
Brain bleeds can occur from excessive suction from the vacuum extractor on the baby’s head. The suction can cause blood vessels to rupture and bleed into the tissue around the skull. The condition may take a few weeks or even months to heal, but it can become severe in some instances.
When the bleeding continues, it will cause pressure on the child’s brain and skull. It leads to brain damage that may affect physical and neurological abilities in severe cases.
Types of Brain Bleeds
- Cephalohematoma- This type of bleed stays in the space underneath the fibrous covering of the skull, and it is less severe. Typically, this hematoma clears up within one to two weeks.
- Subgaleal Hematoma- This type of bleed is rare but severe. It occurs when the blood fills the space directly under the skull. When the vacuum extractors rupture the emissary's veins, they can pool up and cause pressure. If not treated quickly, it can result in brain or spinal cord damage.
Intracranial hemorrhage, or bleeding inside the skull, can lead to rapid brain damage or even death without immediate surgical intervention. A hemorrhage is rare, but it is a highly severe risk of vacuum delivery.
Intracranial hemorrhage can lead to loss of memory or movement. It needs to be recognized quickly after the vacuum extraction is complete so that it can be treated and monitored. The recovery can take a few months.
A retinal hemorrhage, or bleeding behind the eyes, is another common complication of a vacuum extraction procedure. This complication is mild, and it will often go away quickly without medical intervention. Many people believe it is caused by excessive pressure from the tools required for vacuum delivery.
Operative delivery can also put excessive pressure on the baby’s head, resulting in fractures to the skull. Skull fractures range in severity. In severe cases, a skull fracture can cause decreased cerebral function and permanent brain damage.
Types of skull fractures that can affect newborns include:
- Linear - thin, hairline fractures
- Depressed- thin depressions in the skull bone
- Occipital osteodiastasis- severe and rare skull fractures that cause tears to the tissues under the skull
Babies that suffer from severe skull fractures may even have permanent brain damage and development of issues like Cerebral Palsy.
Vacuum-assisted delivery can cause neurological damage that results in cerebral palsy, a neurological disorder that affects motor and developmental skills. According to the Cerebral Palsy Guide, it “can cause problems with posture, manner of walking (gait), muscle tone, and coordination of movement.”
Cerebral Palsy is a disorder that ranges in severity depending on the location and severity of the brain injury. When caused by a birth injury resulting from a vacuum extractor, Cerebral Palsy is preventable.
Jaundice, the yellowing of the skin and eyes, is more likely to develop in babies born with an assisted delivery. Because of the bruising left behind by most vacuum suction cups, babies then have high levels of bilirubin in their blood.
When the liver cannot absorb all of the bilirubin in the blood, it will cause the yellowing of the skin to last longer than usual. A baby can be treated with phototherapy to treat jaundice if this occurs.
Phototherapy is when the baby is kept under a high-intensity light to decrease the toxicity of the bilirubin and flush it out of the body. In severe cases, the baby may need a blood transfusion to remove the bilirubin and improve the appearance of jaundice.
Scalp Lacerations in Operative Vaginal Delivery
Even though doctors will typically use a soft cup for a vaginal delivery, scalp lacerations are still possible. These superficial scalp wounds are the most common vacuum extraction injuries.
The rigid cups, known as the original vacuum extractor, leave a cone-shaped bruise or mark on the baby’s head. It is another reason why many doctors now opt for soft cups to minimize the appearance left behind after the vacuum delivery. The swelling of the face or head will go down after roughly two to three days.
In more severe cases, the vacuum extractors will cause some skin to tear or cut during the procedure. These wounds are superficial and should leave no permanent scarring.
Mothers rely on their doctor’s medical education to safely deliver their baby during vacuum delivery. Medical negligence might have happened if a baby suffered a vacuum extractor's birth injury. It is true whether you have risk factors or not.
Vacuum Extraction Risks to the Mother
Vacuum-assisted deliveries have risks to both the mother and the baby. The mother may be left with a longer postpartum recovery period and a more difficult road ahead if they suffer from common complications of this procedure.
Vacuum delivery complications to the mother include:
- Excessive genital tearing
- Perineal pain
- Difficulty or pain while urinating
- Fecal or urinary incontinence
The vacuum extraction may cause more genital tearing during delivery. To prevent tearing, the doctor may instead perform an episiotomy. This procedure widens the vaginal opening so the doctors can insert the vacuum extractor and have better access to the baby.
If an episiotomy is necessary, the mother can expect more pain and discomfort in the recovery. The incision takes longer to heal and requires special care days and weeks after birth.
Long Term Effects of Vacuum Extractions
Because birth injuries are a common complication of this procedure, there may be effects on the mother and baby for weeks, months, or even years. Both the mother and baby may suffer from the long-term effects of a problematic assisted delivery using vacuum tools in the birth canal.
Vacuum delivery long term effects on the baby may include:
Vacuum delivery long term effects on the mother may include:
- Chronic pelvic pain
- Issues with sexual intercourse
Vacuum extractors can cause pain and injury that can last longer than a few months. Sometimes, these issues can last years or even be lifelong. Talk with a doctor to address any issues or concerns for both mother and baby after a vacuum extraction procedure.
When to Avoid Vacuum-Assisted Vaginal Delivery
Doctors will avoid this procedure when the mother or baby has certain conditions that can lead to more complications or an unsuccessful extraction. These conditions present risk factors that caution doctors from this birthing procedure:
- The mother is less than 34 weeks pregnant.
- The baby has a bone or bleeding disorder.
- The fetal head is not yet halfway through the birth canal.
- The baby is in a breech position.
- The baby cannot fit through the mother’s pelvis.
If these conditions are present, it is not safe to use a vacuum device to remove the baby. Instead, medical professionals will likely recommend a C-section to deliver the baby.
Hire a Medical Malpractice Attorney to Resolve Your Personal Injury Claim
Are you the victim of medical malpractice involving your pregnancy? At Rosenfeld Injury Lawyers, LLC, our personal injury attorneys are legal advocates for injured victims harmed through another's negligence.
Call us today at (888) 424-5757 (toll-free phone number) or use the contact form to schedule a free consultation. All confidential or sensitive information you share with our legal team remains private through an attorney-client relationship.
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