Beth Shilliday and Sarah Jones ,HL
The article first appeared on HL :
Former ‘RHOC’ star Kara Keough tragically lost her baby son during childbirth to a condition called shoulder dystocia. A top doctor tells us that an infant dying from this is a ‘rare’ circumstance.
31-year-old Kara Keough, Real Housewives of Orange County ex-star and her husband Kyle Bosworth were all set to welcome their new son McCoy into the world on April 6 when things went terribly wrong during the delivery and their baby tragically died. The infant suffered from shoulder dystocia, where his shoulder was caught inside Kara’s pelvic region while his head had emerged. The 11 pound and 4 ounce baby spanned 21 inches, and also had his umbilical cord compressed. Dr. Daniel Roshan, NYC’s top high-risk, maternal-fetal OB-GYN EXCLUSIVELY tells HollywoodLife.com about the condition, and why it’s so rare that a baby would die from it during childbirth (pictured above, Kara’s mom and RHOC star Jeana Keough).
“Shoulder dystocia means there was difficulty delivering the baby’s shoulder. So what happens is the baby’s head comes out, but when an obstetrician goes to deliver the shoulder, they can’t. The reason is usually because the baby is too big, the shoulders are too wide, the mother’s pelvis is too small for the baby. The baby’s shoulder gets stuck behind the symphysis pubis, which is the bone right behind where the pubic hair is located,” Dr. Roshan explains.
“In order to get the baby out, the doctor has to use try a few different maneuvers, there are nine or 10 different maneuvers an obstetrician can try to release the baby by hyperflexing the legs, pushing on the pelvic region, rotating the shoulder, delivering the posterior arm, etc. Usually by the fourth or fifth maneuver, the baby comes out,” according to Dr. Roshan. “The last resort after an obstetrician performs all of these maneuvers and still can’t get the baby out is to push the baby’s head back in and do a C-section, but that’s rare. Most of the time the obstetricians are able to do these maneuvers and get the baby out.”
Dr. Roshan says time is of the essence when a baby has shoulder dystocia during a delivery. “Usually you have five minutes to get the baby out after the head is out. A baby gets neurological injuries if they’re not getting enough blood flow or oxygen. But if the doctor can’t get the baby out, the baby might already be in distress because the heart rate was dropping, and then the compressed umbilical cord was not pumping blood to the baby. Then if it takes too long to get the baby out and the baby goes through stress and develops acid in the blood, that can cause brain injuries,” he explains.
Above, pregnant Kara cradles her belly next to her mom Jeana Keough at BravoCon in Nov. 2019.
“So most of the time things work out okay, this type of thing is rare and people shouldn’t get scared,” Dr. Roshan says reassuringly. “But the best intervention is usually prevention. Currently the recommendation is if the mother is having a really huge baby, then she’s given the option of having a C-section or be prepared at the time of delivery to have somebody help. If the baby is over 8lbs 14oz and the mother has diabetes, she needs to be offered a C-section especially if it’s a first baby. If the mother doesn’t have diabetes, then the recommendation for a C-section is for a baby that is over 10lbs sometimes,” Dr. Roshan reveals. This was Kara’s second child, as she and Kyle have a four-year-old daughter Decker. McCoy was well over 10 pounds, with his 11 lb 4 oz weight.
“That’s when the obstetrician’s care comes into the picture. It’s important when they do the sonogram, measure the baby’s size and then they know if the babies are too big. They evaluate the pelvis, evaluate the babies, and talk to the mother about the mode of delivery,” Dr. Roshan continues. “Most of the time an obstetrician can use maneuvers to get the baby out. But there are times it leads to nerve injuries, something we call Erb’s Palsy, where the baby could have paralysis of the network of nerves that sends signals from the spinal cord to the shoulder, arm, and hand. Sometimes the condition is temporary, sometimes it’s permanent.” Our thoughts go out to Kara and Kyle during this heartbreaking time.