MDLinxBaby Slashed in the Face During C-section: These Cases are Rare, but Almost Always End in a Lawsuit

Recent data indicates that fetal lacerations during cesarean deliveries, while rare, present significant clinical and medicolegal considerations. Understanding risk factors and implementing preventive protocols can help reduce these incidents, which affect between 0.4% to 3.1% of newborns delivered via C-section.

Key Points:

• Emergency C-sections carry heightened risk factors for fetal lacerations, particularly when combined with premature rupture of membranes or meconium-stained amniotic fluid. Surgical teams must balance the need for rapid intervention with precise technique.
• Clinical risk factors include thin uterine walls, fetal positioning against the incision site, and proximity to the placental membrane. These anatomical considerations require specific surgical adaptations.
• Some surgeons employ blunt instruments for the final uterine layer incision as a preventive measure, particularly in cases with identified risk factors or atypical fetal positioning.
• Most injuries occur on the face, scalp, and extremities. Treatment typically involves adhesive glue or dissolvable sutures, with deeper wounds requiring layered closure and specialist intervention.
• Although newborns generally demonstrate excellent healing capacity due to rapid skin regeneration, these incidents frequently result in litigation, particularly when deviations from standard protocols can be demonstrated.

“For instance, a thinner-than-normal uterine wall or a fetus positioned directly against the incision site can make accidental contact with surgical instruments more likely.”
— Stewart Parnacott, CRNA, Nurse Anesthetist and Chief Clinical Officer at Ready Wellness

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