Fetal Macrosomia Birth Injury Lawsuits

Fetal macrosomia is a prenatal condition in which the baby grows too big making vaginal delivery risky. Failing to diagnose and properly manage fetal macrosomia can lead to babies getting stuck during delivery and serious birth injuries. On this page we will look at fetal macrosomia birth injury lawsuits.

About Fetal Macrosomia

Fetal macrosomia refers to a fetus being unusually large before birth. While there are no universal diagnostic criteria, a baby weighing more than 8 pounds, 13 ounces at birth is generally considered macrosomic. The average birth weight is around seven pounds.

This condition is fairly common, affecting about 10% of all pregnancies. It is even more prevalent among mothers with gestational diabetes, who have a 50% chance of delivering a macrosomic baby. Genetics can also play a significant role; mothers who have previously delivered a macrosomic baby are up to ten times more likely to do so again.

Fetal macrosomia poses significant risks, making such pregnancies high-risk. An overly large baby can have difficulty passing through the birth canal, leading to complications with vaginal delivery, a situation known as cephalopelvic disproportion. Accurate measurement and estimation of fetal weight during pregnancy are crucial. Early diagnosis of fetal macrosomia is essential to prevent complications such as the need for resuscitation, birth injuries, and even death for both mother and baby.

Diagnosing Fetal Macrosomia

It is very important for doctors to monitor for and timely diagnose fetal macrosomia when it occurs during pregnancy. Diagnosing macrosomia in advance is critically important to avoiding complications during delivery that can cause major birth injuries.

Measuring fetal weight and diagnosing fetal macrosomia is complex and notoriously difficult. This challenge arises because there is no practical way to weigh a fetus inside the womb. Obviously, you cannot take the fetus out and put it on a scale. Imaging tools like sonograms and ultrasounds provide visual images but cannot accurately measure or estimate fetal weight.

In the third trimester, ultrasound images can help estimate fetal weight by taking various measurements of the fetus. However, the formula used for these calculations is based on averages, making it less accurate for fetuses with abnormally large heads, abdomens, or long bones. Growth pattern analysis from earlier ultrasound images is a more effective method for diagnosing macrosomia. Doctors usually use 2 indicators to diagnose fetal macrosomia: (1) fundal height, and (2) amniotic fluid levels.

Causes of Fetal Macrosomia

One known cause of fetal macrosomia is somewhat obvious: genetics. Physical traits like body size and obesity are passed on through genetic inheritance. So physically large or obese parents are more likely to have babies that are abnormally large.

The baby’s gender also factors in. Male babies are much more likely to be macrosomic than female babies. Again, the reason for this is sort of obvious: males babies tend to be bigger than female babies. Another key cause/risk factor for fetal macrosomia is diabetes. Mothers who have diabetes prior to getting pregnant or who develop gestational diabetes during pregnancy are 10 times more likely to have macrosomic babies.

Dangers of Fetal Macrosomia

The primary risk posed by fetal macrosomia is that the baby is highly likely to become stuck or suffer physical trauma during a normal vaginal delivery. This size mismatch between the mother’s pelvis and the baby’s head is known as cephalopelvic disproportion. When fetal macrosomia is diagnosed in advance, this issue can be avoided by scheduling a C-section.

If fetal macrosomia is not diagnosed beforehand, it can lead to hazardous conditions during vaginal delivery. Complications like shoulder dystocia become much more likely, and the risk of the baby getting stuck in the birth canal increases significantly. When a baby experiences a difficult passage through the birth canal, the risk of birth injuries is very real. A competent OB/GYN will discuss the option of a Caesarean section and the associated risks of vaginal delivery for a macrosomic baby with the patient.

Regarding induction of labor due to suspected fetal macrosomia, the American Board of Obstetrics and Gynecology guidelines state that “Suspected fetal macrosomia is not an indication for induction of labor, because induction does not improve maternal or fetal outcomes.” However, a C-section is a different matter. According to ACOG guidelines, “With an estimated fetal weight of greater than 4,500 g, a prolonged second stage of labor or arrest of descent in the second stage is an indication for cesarean delivery.”

High birth weight also puts newborns at risk for subconjunctival hemorrhage, a temporary and harmless condition caused by burst blood vessels in the eyes.

Negligent Failure to Diagnose Fetal Macrosomia

If fetal macrosomia is diagnosed in a timely manner, it can typically be managed safely with an early C-section delivery. The standard of care requires healthcare providers to consider the use of a C-section and discuss with the mother the options and risks, particularly due to the higher risk of shoulder dystocia and subsequent brachial plexus injury.

However, if fetal macrosomia is not properly diagnosed, it can lead to dangerous complications during delivery. A baby that is too large is much more likely to become stuck in the birth canal. Delivery complications, such as shoulder dystocia, are far more likely in cases of undiagnosed fetal macrosomia. When these complications arise, doctors in the delivery room must use emergency techniques and tools, often resulting in birth injuries. Damage to the brachial plexus can lead to total or partial paralysis of the baby’s upper extremity (Erb’s Palsy). Additionally, oxygen deprivation can lead to cerebral palsy.

Misdiagnosis of macrosomia is not the only issue leading to birth injuries and medical malpractice lawsuits. Our lawyers frequently encounter cases where doctors were aware of the risk of macrosomia but failed to adjust delivery plans accordingly. A common mistake, as seen in the settlements and verdicts below, involves using a vacuum to deliver a baby suspected to weigh over 4,500 grams. Medical literature clearly indicates that a vacuum is contraindicated for these babies, yet many obstetricians either overlook this information or proceed regardless.

Fetal Macrosomia Malpractice Verdicts and Settlements

Below are summaries of verdicts and settlements in medical malpractice cases involving birth injuries that were caused by a negligent failure to diagnose fetal macrosomia.

$1,000,000 Settlement (South Carolina 2023): The baby suffered birth-related nerve avulsion and/or rupture of the brachial plexus of his right shoulder, leading to permanent limited motion of his right arm, during a vaginal delivery. The lawsuit alleged that the defendants were negligent in failing to consider risk factors indicating the fetus was possibly macrosomic and at risk for shoulder dystocia; failing to appropriately manage labor to avoid shoulder dystocia.

$525,000 Verdict (New York 2022): The baby suffered a left brachial plexus injury, resulting in decreased motion in her left upper extremity, during her birth managed by defendant. The lawsuit asserted that the defendant failed to notify the hospital that the infant may be macrosomic prior to her birth and was negligent and careless in failing to heed the plaintiff mother’s condition and departing from

$956,504 Verdict (Utah 2021): Shoulder dystocia was encountered during delivery of a very large baby. The defendants opted for vacuum assisted delivery which caused a brachial plexus injury. The lawsuit contended that because her baby weighed 12 pounds, he should have been delivered via C-Section, and had a C-Section been done, the injury would never have occurred. The lawsuit claimed that the defendants were negligent in failing to diagnose fetal macrosomia in advance.

$975,000 Verdict (California 2019): Complications during attempted vaginal delivery resulted in loss of oxygen to the baby causing cerebral palsy with cognitive defects. The lawsuit alleged that the OB/GYN was negligent in his failure to diagnose macrosomia and opt for a scheduled c-section that would have avoided the injuries.

$850,000 Verdict (New York 2019): The defendants were accused of negligently failing to diagnose and manage fetal macrosomia despite the fact that there were several major risk factors for macrosomia, including gestational diabetes. As a result, the baby got stuck during vaginal delivery and had to be delivered via vacuum extraction, which resulted in a brachial plexus injury.

$1,500,000 Verdict (Illinois 2019): Lawsuit alleged that the doctor negligently failed to perform necessary testing to diagnose fetal macrosomia. As a result, should dystocia occurred during vaginal delivery and the effort to overcome this complication cause permanent injuries to the baby’s arm.

Contact Us About Fetal Macrosomia Malpractice

If your baby was injury during birth because of medical malpractice related to fetal macrosomia, contact our national birth injury lawyers today at 800-553-8082 or contact us online.

Fetal Macrosomia Research and Studies

Ewington, Lauren, et al. “Multivariable prediction models for fetal macrosomia and large for gestational age: A systematic review.” BJOG: An International Journal of Obstetrics & Gynaecology (2024).

Chen, Yu-Hsuan, et al. “Association between maternal factors and fetal macrosomia in full-term singleton births.” Journal of the Chinese Medical Association 86.3 (2023): 324-329.

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