Arm pinned behind head?

[GinaRae]

After reading the Shoulder Dystocia thread, I have a question:

My sister in law (at the hospital) pushed 1.5 hours and literally gave up (after an 18 hour labor). Baby was in the canal, but the head not all the way out and they performed a section. She went sepsis later, I assume from the contamination of having his head there that long and everyone copping a feel, then having it pulled up and out.

Anyway, sounds like she would have HAD to have a section no matter what. His arm was purple, almost black at the shoulder. They feel it was pinned behind his head. Short of breaking it off, I don't know as anything could be done. I do not know yet of they tried forceps or the vacuum and I would imagine that would just damage him and not help in this situation, but luckily it seems he is moving the arm and it was warm and began pinking up at the fingers almost immediately.

I haven't heard of this one yet. Was it a fluke or is there something that a MW could do?

[KingsDaughter76]

Couple of questions for you-

Was she induced or did she go into labor on her own?

Was she confined to the hospital bed or allowed to move about freely?

Did she have an epidural?

[flapjack]

A nuchal hand would NOT be cause for a section- something like 8% of babies are born with their hands alongside their heads. This (if I'm reading it right, this baby actually presented with his elbow first and the hand all the way behind his head) would be very problematic to deliver vaginally and the section probably saved two lives.
The most likely cause of the malposition, as Kellina suggests, is iatrogenic in nature and brought about by her trying to conform to the hospital's demands on her. Another possibility would be that her waters broke before baby was in a good position and he simply got trapped like that.

[Peppamint]

Ditto what the others said.

My last baby was born with nuchal arm, not fun at all but doable... but I can visualize malpositions that just wouldn't happen without injury (or worse) to mom and baby.

[GinaRae]

Unfortunately I don't have all the answers to the questions, but she was not induced. She went into labor after a long car ride.

They believe the arm was so far behind the head it wasn't a hand next to the head and was not elbow first. I believe THEY believe the elbow was at the back of the head. The arm was purple/shoulder was practiclly black because circulation had been cut for so long.

Wish I had the answers to the other questions, but I only get info second hand from my mother at this point.