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Under normal circumstances, children are born head-first with the chin tucked facing the chest. In a face presentation, the chin is not tucked. This prevents the engagement of the head and slows labor. This increases risk of head trauma, prolonged labor, and breathing-related complications.
In most cases, medical staff will use a finger to determine the position of the baby. If they have reason to believe an abnormal presentation will take place, they can confirm with an ultrasound and determine a course of action. This includes extra monitoring and often requires a C-Section. Staff must also be ready to intubate following delivery.
A face presentation diagnosis often comes in the first or second stage of labor following examination of a dilated cervix. Face presentation may be confused with breech presentation, which is why it is extremely important that a skilled professional be present during any risky delivery or abnormal presentation.
There are three types distinctive types of face presentation:
Informed consent and full disclosure of available delivery options must always be given when there is risk of a face presentation. Trauma is extremely likely to occur with vaginal delivery. Therefore it is imperative that parents are warned that their baby risks injury without a C-section.
In any face presentation, if problems persist despite normal contractions, delivery via C-section is required. The baby is at increased risk of trauma when the face presents. Doctors should not try to internally manipulate the baby. Medical staff must also take care not to use vacuum extractors or manual extraction to remove baby from the uterine cavity. In addition, when forceps are used, there is a significant increase in trauma risk.
Abnormalities of the fetal heart rate are also more likely to occur during a face presentation. This is why it is crucial that babies be closely monitored during labor -- with an external heart monitoring device. Internal devices may cause injuries if improperly placed. If internal monitoring is unavoidable, the electrode must be cautiously placed over the forehead, jaw, or cheekbone to minimize trauma risk.
It is essential that close monitoring of the baby occurs during all stages. Delivery must be handled by a physician with sufficient experience in this area. The doctor must also quickly elect for a C-section delivery if signs of fetal distress occur. Once a face presentation is identified, the physician must check for pelvic adequacy. When the pelvis is too small, a C-section is recommended.
Since difficulty breathing can occur in babies with face presentation, proper equipment and staff to intubate the baby should be made available at the time of delivery.
Informed consent is required when a mother has a child with face presentation. She must be given the option of a C-section versus a vaginal birth. A mother may opt for a C-section to avoid trauma to the child. In addition to giving clear, concise explanations of the risks and benefits of each delivery method, the doctor must explain and get consent from the mother if forceps or oxytocin are to be used.
Failure to follow any of the aforementioned standards of care is considered negligence. If this negligence results in injury to mother or child, it is medical malpractice.
The plaintiff went to a Chicago hospital for delivery of twins via cesarean section. In the delivery room, a suspicious rash was recognized on one of the twins and later, fecal and urine cultures confirmed the presence of candida. She was started on prophylactic anti-fungal medicine and is healthy. The other twin was clear of any rash and though she was at risk for fungal infection, she was not treated in a timely manner. Later, a head ultrasound and MRI confirmed the diagnosis and damage to her brain. A lawsuit was filed on the plaintiff’s behalf. The case was vigorously defended by lawyers for the physician and the hospital that he worked for over 3 years. Eventually, a mediation took place at which time the defendants offered $3,000,000 to settle, which the plaintiff rejected. It was not until trial that the case settled for $10,000,000.
Birth injury cases are among the most complicated medical malpractice cases to litigate. With years of experience in birth trauma litigation our legal team has the skills, the resources and experience necessary to address and win a wide variety of birth injury cases. Our legal team has secured millions of dollars in compensation for birth injury victims.
With decades of hands-on experience working with top healthcare professionals in labor and delivery, our legal team has access to some of the top medical professionals in the world. As in many types of medical malpractice cases, high quality expert are essential in obtaining justice.
Our firm was established to focus on the unique needs of our clients. We work with top medical, life-planning, and forensics experts to determine the causes and extent of injuries, prognoses of victims, and areas of medical negligence. Our passion for helping birth injury victims allows our attorneys to deliver unrivaled legal services for your family.
Willens Law Offices have helped the families of children across Illinois get the compensation they need for a secure future.
We strive to give the utmost personal attention to each child and family we represent.