Compound Presentation and Connection to Birth Injuries

Pregnancy can be a time of joy, reflection, and anxious anticipation. No one expects complications, but 8% of pregnancies have them. One such complication is compound presentation, which happens when a fetus is abnormally positioned in the birth canal. Optimally, a fetus travels down the birth canal headfirst, facing the mother’s back. However, compound presentation means that a fetus is typically positioned with an arm, hand, foot, or leg near the body part closest to the birth canal opening, such as the head or buttocks. For example, if a baby’s head is closest to the birth canal, then an arm positioned next to the head is a common manifestation of compound presentation.

How Common is Compound Presentation of the Fetus?

Approximately 3% to 4% of birth presentations are abnormal, including breech and brow and face presenting births. Compound presentation composes a small percentage of that total, occurring in fewer than 0.004% of cases. Although rare, 1 out of 250 all the way up to 1 out of 1,500 pregnant women experience births complicated by compound presentation.

Potential Reasons for Compound Presentation at Birth

One reason for compound presentation is that the fetus has a lot of space in the womb. For example, a fetus in the second trimester may have enough room for an arm or leg to untuck and extend toward the head. A small fetus and prematurity may cause the condition. Other conditions that predispose a pregnancy to this condition are multiple fetuses (one fetus pushes the limb of another alongside the head),  polyhydramnios (excess amniotic fluid), cephalopelvic disproportion to the fetus’s size (large pelvis to the tiny fetus), premature rupture of membranes, and small size for the baby’s gestational age.

Yet another reason that an extremity flows downward toward the birth canal is the mother’s water breaking when the fetus has not descended toward it. When that happens, the amniotic fluid causes a fetal arm, leg, foot, hand, or umbilical cord to lower to the birth canal.

Process to Diagnose Compound Presentation

As a woman’s due date approaches, her doctor may order ultrasounds to check the fetus’s presentation. Additionally, pelvic exams near delivery may reveal the intruding limb or other form advancing before the head. A physician must distinguish between more common abnormal presentations like breech or transverse fetal lie (fetus is sideways in the womb) and a rarer complication, compound presentation, to avoid making mistakes in delivery decisions.

Tailored Approaches to Manage Compound Presentation Depending on What Happens During Labor

Treatment for compound presentation is tailored to each patient. It depends on what happens during labor, whether the fetus changes position or the delivery physician can maneuver it manually. When the fetus does not shift its position, it may cause labor to slow or lead to shoulder dystocia, when the shoulders get stuck while the head moves toward delivery. When the fetus cannot be delivered safely, the treatment may be a necessary cesarean section (C-section).

Different Ways Medical Malpractice can Occur with Compound Presentation

As a woman nears her delivery date, her OB-GYN should check the baby’s presentation, take ultrasounds, and perform pelvic exams during labor and delivery to closely monitor the fetus’s position. When the doctor fails to perform the appropriate exams and order the ultrasounds, they may be found negligent. Without the ultrasound, pelvic exam, or proper training or experience, a pregnant woman’s physician may misdiagnose compound presentation. A misdiagnosis can lead to mismanagement of the malpresentation. As such, a doctor may not treat compound presentation during labor and delivery properly, whether through gentle pressure to right the fetus’s position or performing a C-section soon enough.

Possible Consequences of Negligence with Compound Presentation

One complication resulting from medical malpractice with compound presentation or mismanagement of the condition is prolonged labor that may take a cesarean section to resolve when the baby or mother is endangered. Other complications include shoulder dystocia. When the baby’s shoulder becomes wedged in the pelvis, Erb’s palsy or a brachial plexus injury may occur, both of which may lead to injury to the arms or the brachial plexus, a neural network near the neck. The nerve damage may cause arm weakness or paralysis. Whichever extremity advances with or before the head may also suffer damage. Moreover, when the umbilical cord is delivered before the child, the doctor must perform an emergency cesarean section to save the infant’s life. Once the umbilical cord compresses in the birth canal, known as umbilical cord prolapse, the baby’s oxygen source is cut off, which can cause brain damage, cerebral palsy, or death.

Call our Compound Presentation Negligence Attorneys in New Jersey

You may sense that your doctor did something wrong to cause injury or death to your baby, but you may not know for sure. One way to determine whether your doctor was negligent in handling your compound presentation during labor and delivery is by consulting a knowledgeable birth injury lawyer on our team. Our extensive experience with birth injury investigations makes us highly adept at confirming medical malpractice and identifying what happened to injure mothers and their babies during labor and delivery.

What our dedicated birth injury legal team does is tackle everything necessary to prove medical malpractice in a compound presentation case. We can assist you with discovering evidence to prove that your medical provider failed to uphold the sufficient standard of care, and therefore, should be held liable for damages. Your baby may need special care for the rest of their life, in addition to their intensive medical needs in the short term, and the negligent doctor or medical facility should be held responsible for paying for your child’s needs and the additional costs associated with their injuries.

We understand that you dreamed of a healthy baby, you are suffering grief due to preventable errors that caused them harm, and our attorneys will readily answer your questions, carefully prepare your case to obtain the compensation and justice you deserve, and compassionately guide you through the process of pursuing a claim. It is our mission to serve parents and families like you. If your baby was injured as a result of medical malpractice with compound presentation at birth, we invite you to reach out to our attorneys today for a free consultation. You can reach us by filling out our convenient form or calling (866)-708-8617 for immediate assistance.