Cephalopelvic Disproportion & Legal Liability for Related Malpractice
Sometimes the head of a fetus is very large compared to the pelvis of the mother. This may prevent the head from passing through the bones in the narrowest part of the pelvis during a vaginal birth. A doctor may not recognize this problem, known as cephalopelvic disproportion, until labor begins. In other cases, a doctor may note a risk of the condition during pregnancy if the baby is unusually large, or if the baby is positioned abnormally.
Cephalopelvic disproportion may arise when the maternal pelvis is small or unusually shaped, due to genetic factors, tumors, injuries, or other causes. The condition also may develop from genetic factors linked to fetal macrosomia, or from gestational diabetes.
Symptoms and Diagnosis of Cephalopelvic Disproportion
A doctor may suspect cephalopelvic disproportion when the labor and delivery process stalls. In other words, the mother experiences contractions, but the cervix fails to dilate in preparation for the baby passing through the birth canal, and the baby does not progress. A doctor should monitor the progress of labor to determine whether a vaginal delivery remains safe.
If a doctor recognizes cephalopelvic disproportion or its risk factors before childbirth, they may suggest trying to reposition the baby to allow their head to pass through the pelvis more easily. They also may urge the mother to undergo a C-section. In other cases, a doctor may recommend that a mother proceed with vaginal labor initially and then schedule a C-section if labor stalls.
Complications of Cephalopelvic Disproportion
If this condition is promptly diagnosed and addressed, neither the mother nor the child likely will suffer any consequences from cephalopelvic disproportion. However, disregarding this condition and forcing the mother to endure obstructed labor can cause permanent disabilities or even death. This is because uterine rupture may result, causing a hemorrhage, or the mother may suffer infections inside the uterus, bladder, or birth canal. Meanwhile, the baby may suffer various birth injuries when labor fails to progress. These include shoulder dystocia, when the shoulders of the child get trapped behind the pubic bone of the mother. In severe cases, stillbirth (fetal death) may occur.
Legal Claims Based on Cephalopelvic Disproportion Complications
Steps for identifying and responding to cephalopelvic disproportion have been clearly established in the medical profession. If a doctor fails to follow the appropriate steps, or does not perform them competently, they may be liable for any injuries sustained by the mother and the child because of these errors. In a medical malpractice lawsuit, a family can pursue damages for the medical expenses and pain and suffering caused by cephalopelvic disproportion complications. This involves proving that the defendant fell short of the professional standard of care in diagnosing, monitoring, or treating this condition. For example, they might have failed to schedule a C-section once they realized that labor could not progress, or they might have attempted to reposition or extract an obstructed fetus with too much force.
Before reaching a favorable outcome, a medical malpractice case must pass through certain procedural hurdles. These may include an affidavit or certificate of merit provided by a medical expert. An affidavit of merit essentially confirms that the case has a legitimate basis so that doctors and hospitals are not wasting time and resources in defending against frivolous claims. Even the strongest claims must comply with the statute of limitations, moreover, which provides the time window in which a case must be filed. A medical malpractice case brought after the statute of limitations has expired will face dismissal in most situations.
