What Causes Fetal Lacerations?

Fetal lacerations may be caused during a cesarean section (C-section) delivery if the physician cuts the infant using a device such as scissors, forceps, or a scalpel. Fetal lacerations are classified in three levels:

• Mild: slight nicks that only affect the skin.
• Moderate: cuts that involve both the skin and the underlying muscle.
• Severe: lacerations that cut through the skin and muscle to the bone or other structures, such as the nerves.

Fetal lacerations are uncommon, although studies show they often go unreported. A 2009 study from the American Journal of Obstetrics & Gynecology (AJOG) reports that fetal laceration occurs in about 0.7 to 1.9 percent of deliveries. When they do occur, 70 percent of them affect the head, face, or ears; 20 percent occur below the waist on the infant’s ankles, legs, or buttocks; and 10 percent occur to the back, which may create a risk for damage to the spinal cord.

In cases where the injury is mild, it may heal on its own with no medical intervention. If the injury is moderate, the physician may need to use a topical adhesive, but surgical treatment should not be necessary in most cases. However, severe fetal lacerations will likely need to be treated with immediate surgical repair, and there may be long-term consequences for the infant.

According to an Obstetrics and Gynecology study from 2018, of the 5,036 C-sections recorded during the study period, there were a total of 14 lacerations: 12 of them were classified as mild, one was classified as moderate, and one was classified as severe.

Possible Risk Factors for Fetal Lacerations

Fetal lacerations are more likely to occur in situations involving:

• Emergency C-sections because the baby is in distress, particularly during active labor.
• A “J” or inverted “T” incision being made into the uterus, rather than a vertical or transverse incision.
• An inexperienced surgeon or physician.

There are steps a surgeon could potentially take to reduce the likelihood of a fetal laceration, such as meticulously suctioning the site where the incision is being performed, using a dulled or bandage-covered tool to perform the cut with minimum risk of a deep incision, and removing the retractors that are keeping the incision open before delivery. However, an inexperienced surgeon may overlook these preventative options and fail to mitigate the risk of a fetal laceration.

Complications Associated with Fetal Lacerations

There are a number of long-term consequences that may accompany fetal lacerations, including:

Nerve Damage

Depending on where the injury occurred, if the cut was deep, it could cause nerve damage, impacting mobility in different parts of the body. For example, if a cut damages the brachial plexis, the network of nerves in the shoulder that controls sensation and movement in the arm and hand, an infant may suffer weakness or loss of mobility. This can result in a condition called Erb’s palsy, which occurs in one to two of every 1,000 births according to the American Academy of Orthopaedic Surgeons (AAOS). If the fetal laceration occurred to the back, it could cut through the spinal cord, leading to paralysis.

The majority of fetal laceration cases occur on the head, face, and ears. If the scalpel cuts through a nerve in the infant’s face, it may suffer from facial nerve paralysis.

Disfigurement

While a tiny scar can seem inconspicuous on your newborn child, it may elongate as your child grows. The 2009 AJOG study reports on a case in which an infant sustained a cut that left a scar about two centimeters in length. Twelve years later, it had grown to 10 centimeters in length and developed an irregular appearance as the skin stretched. Because of the scar’s size and appearance, it could potentially have an impact on the sufferer’s psychological well-being.

Other Complications

If an infant suffers a fetal laceration to the eyes, they may experience loss of vision or blindness. If the laceration occurs around the ears, particularly in the event of a moderate or severe laceration, the baby may suffer hearing loss or deafness. In addition, like with any cut, there is an increase in the possibility of infection.

If your child is suffering because of a fetal laceration, you are not alone. Oftentimes, new parents may not understand the long-term impact a birth injury could have on the child’s life and their own finances. The costs of possible physical therapy, surgical procedures, and doctor’s appointments can add up fast.

If you believe your child’s fetal laceration was caused by a negligent physician, you may be entitled to compensation for your child’s injuries. For a free case review, contact the Birth Injury Lawyers Group at (800) 222-9529.