(2) Trauma to the birth canal may result during delivery due to the size of
the infant. The trauma may be lacerations of the vagina or of the perineum.
(3) Trauma to the fetus as a result of pressure placed on it by the delivery
process (especially the head and neck), may cause:
(a) Damage to the brachial plexus (nerve injury). This includes a
network of lower cervical and upper dorsal spinal nerves, supply arm, forearm, and
hand, may have flaccid arm, hand, forearm, and hand rotates inward. Damage to the
brachial plexus may be referred to as Erb's Palsy or Erb-Duchenne diseases. Damage
is not usually permanent.
(b) Dislocation of the cervical vertebrae as a result of traction to get the
(c) Fracture of the clavicle. This is the most common problem and is
done during delivery of the shoulders.
(d) Cerebral hemorrhage (intracranial). This is due to repeated
pounding on the pelvis.
c. Medical Interventions for Delivery of the Oversized Infant.
Assessment of feto-pelvic size to determine if vaginal delivery is
Monitor the patient's progress closely.
Perform cesarean section if the infant fails to descend.
(4) Fracture, intentionally, the humerus or clavicle to decrease the size of
the fetus shoulder girdle and facilitate delivery. This is done if shoulder dystocia results
during vaginal delivery. The mother may flex her thighs on her abdomen to enlarge her
maternal pelvis inlet. Suprapubic pressure may be applied by someone to collapse the
diameter of the shoulders.
d. Nursing Interventions.
Monitor progress of the labor and the FHT's closely for any signs of fetal
Keep the mother and father informed of the progress.
Give emotional support to the parents.