Birth injuries occur around the time of delivery, resulting in cerebral palsy, Erb’s palsy and other permanent neurological injuries. The risk of injury increases with multiple gestation births, such as twins and triplets. The American College of Obstetrics and Gynecology (ACOG) has issued recommendations to minimize the risk of injury during management of a twin or triplet delivery.
The ACOG recommendations recognize that over 100,000 babies are born from multifetal gestations each year in the U.S. The number has steadily increased since 1980 due to the use of reproductive technology. To capture the risk posed by these births, ACOG states: “Although multifetal births account for only 3% of all live births, they are responsible for a disproportionate share of perinatal morbidity and mortality.” The risk of a poor outcome increases with the number of fetuses.
These pregnancies can be complicated by a variety of associated conditions: gestational diabetes, hypertension, preeclampsia, acute fatty liver with coagulopathy, pulmonary embolism, twin-twin transfusion syndrome, and preterm delivery.
Management of these pregnancies by an obstetrician requires careful examination and monitoring, and thorough counseling of the mom, typically by a high-risk specialist. Cervical length should be assessed to determine the risk of preterm delivery. A cerclage may be an option to reduce this risk. Other possible interventions include bed rest, uterine activity monitoring, tocolytics and selective fetal termination.
Under Ohio law, when birth injuries result from substandard management of multiple gestation births, a claim for medical negligence may exist. Given the complexity of these cases, a qualified medical malpractice attorney will need to carefully review all treatment records and ultrasound imaging with an expert in the field to determine if a meritorious claim exists.