Abnormal Position and Presentation Complications

Breech Births, Macrosomia & Other Delivery Problems May Cause Birth Injuries | Abnormal Position or Presentation

What Way Should a Baby Come Out During Birth?

Vertex presentation is the ‘normal’ way that a baby is typically positioned for birth, and the safest way for the baby to be born. In vertex presentation, the baby is positioned head-first with their occiput (the part of the head close to the base of the skull) entering the birth canal first. In this position, the baby’s chin is tucked into their chest and they are facing the mother’s back (occipito-anterior position). Any position other than vertex position is abnormal and can make vaginal delivery much more difficult or sometimes impossible. If a baby’s chin isn’t tucked into their chest, they may come out face-first (face presentation), which can cause birth injury.

What Happens if a Baby Isn’t in the Vertex Position During Birth?

Before delivery, it is critical that the fetus is in the standard vertex presentation and within the normal range for weight and size. This helps ensure the safety of both baby and mother during labor. When the baby’s size or position is abnormal, physician intervention is usually warranted. This may mean simple manual procedures to help reposition the baby or, in many cases, a planned C-section delivery. The failure of healthcare professionals to identify and quickly resolve issues related to fetal size, weight, and presentation is medical malpractice. There are numerous complications related to abnormal weight, size, abnormal position or presentation. Some of the malpositions and malpresentations that can occur during birth include :

What is a Compound Presentation?

In the safest presentation (vertex presentation), the baby is born head first, with the rest of the body following. In a compound presentation, however, there are multiple presenting parts. Most commonly, this means that the baby’s head and an arm come out first at the same time. Sometimes compound presentation can occur with twins where the head of the first twin presents with the extremity of the second twin.

Risk factors for compound presentation include:

  • Prematurity
  • Intrauterine growth restriction (IUGR)
  • Multiple gestation (twins, triplets, etc.)
  • Polyhydramnios
  • A large pelvis
  • External cephalic version
  • Rupture of membranes at high station

Compound presentations can be detected via ultrasound before the mother’s water breaks. During labor, compound presentation is identified as an irregular finding during cervical examination.

If a mother has polyhydramnios, the risk of compound presentation is higher, as the flow of amniotic fluid when the membranes rupture can sweep extremities into the birth canal, or cause a cord prolapse, which is a medical emergency. If compound presentation continues, it is likely to cause dystocia (the baby becoming stuck in the birth canal), which is also a medical emergency. Often, the safest way to deliver a baby with compound presentation is C-section, because complications like dystocia and cord prolapse carry risks of severe adverse outcomes, including cerebral palsy, intellectual and developmental disabilities, and hypoxic-ischemic encephalopathy (HIE).

What is a Limb Presentation?

Limb presentation during childbirth means that the part of the baby’s body that emerges first is a limb – an arm or a leg. Babies with limb presentation can’t be delivered vaginally; they must be delivered quickly via emergency C-section. Limb presentation poses a large risk for dystocia (the baby getting stuck on the mother’s pelvis), which is a medical emergency.


Legal Help for Birth Injuries from Abnormal Position or Presentation

Michigan-Based Birth Injury Attorneys with a National Presence

Reiter & Walsh, PC | Legal Help for Birth Injuries from Abnormal Position or PresentationThe award-winning birth injury attorneys at Reiter & Walsh, PC have over 100 years of joint experience handling birth trauma cases related to abnormal position or presentation. If you believe your loved one’s birth injury resulted from an instance of medical malpractice, you may be entitled to compensation from a medical malpractice or personal injury case. Reiter & Walsh, P.C. handles cases all over the country, in states such as Michigan, Ohio, Pennsylvania, Texas, Tennessee, Wisconsin, Arkansas, Mississippi, Washington D.C., and more. During your free legal consultation, our birth injury attorneys will discuss your case with you, determine in negligence caused your loved one’s injuries, identify the negligent party, and discuss your legal options with you.

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