Asynclitic Presentation-Negligence?

[Lulu1027]

I was severely injured in an emergency ventouse delivery in September. I was induced and after about two hours of pushing I developed an infection and fever and the baby went into distress. He was safely delivered via ventouse and spent two days in the nicu but I suffered a 3a perineal tear, bilateral tears along my labia minora and clitoral hood, and a mild bladder prolapse. After the doctor left, the nurse told me that the baby wouldn't come out because his head was cocked to one side. She was correct- the ventouse mark was on the right side of the baby's head, above his ear. I didn't think much of this at the time but I have recently learned that this is called an asynclitic presentation and that most asynclitic babies are born via c-section to avoid precisely the situation that we suffered. AIBU to think that this constitutes medical negligence? Thankfully, I suffered the worst of it but this situation was dangerous for both of us. At very least, shouldn't I have been informed that the baby was malpositioned while I was pushing and given the option of a section before there was an emergency?

She told you for a reason. She wanted you to know. So yes, do raise a complaint, with or without the input of PALS. That doctor does need a moment of externally imposed self reflection, if nothing else.

You should contact a clinical negligence solicitor experienced in maternal birth injuries for advice.

I think you would benefit from a birth debrief to discuss it. I thought if a baby's head was low enough to consider a ventouse delivery then a c section would be very tricky, as it would mean disimpacting the head from the birth canal ?

My DC head was asynclitic, the Registrar manually repositioned her head and she delivered vaginally. It doesn't necessarily mean a c section

midwifethinking.com/2015/09/09/asynclitism-a-well-aligned-baby-or-a-tilted-head/

This might be useful

I have sought the advice of a lawyer and am waiting to hear back. I am in the US so there is no debrief service.

@FusciasBright21 Thanks for the info. I have heard of repositioning the baby. Clearly it was too late for a c-section once he was low enough for the ventouse but I don't know why I wasn't informed of the issue and offered one earlier. Moreover, I don't know why they didn't attempt to reposition him once he was low enough for the ventouse.

My baby's head was transverse and asynclitic. They attempted a ventouse and a manual rotation and I then had a crash cs. It was actually really difficult to tell her position because I'd been fully dilated for 5hrs and everything was very swollen. I know she was asynclitic because they noted the tearing from the ventouse was above dd's right ear. She was injured and so was I. I also haemorrhaged.

A debrief was really helpful for me. It's a shame you don't have them there.

I've never considered it negligence. They had to act in the moment and try and deliver DD quickly.

Your injuries sound horrific , I hope you have proper follow up treatment in place. I would complain about the lack of information about your delivery and as someone else suggested request a debrief on your whole experience. By all means consult a solicitor as they can be well versed in communicating with medical professionals but emphasise that you are not ambulance chasing, you would just like an explanation as to why things went so wrong. Wishing you and your family much love, good health and happiness

Thing is an asynclitic presentation can come and go. If it hasn’t been documented as an issue prior to the delivery you will struggle to prove when it occurred. Also an early asynclitic presentation will often correct itself during labour.

2 hours of pushing while at the upper end of what’s considered a normal timeframe is still within normal limits especially if it was your first baby.

Perineal trauma is a recognised risk of childbirth so unless there’s a lack of documentation about the ventouse procedure being done again you might struggle.

It can be such a subtle difference in what you feel during a vaginal examination that I don’t think it would be considered negligent for it to not be picked up. However if there weren’t regular examinations, etc there might be more of a case. I’m sorry you went through this.

If its the U S I'm sure the lawyers will be all over it. Don't think anyone on mumsnet can really answer your question tbh