Placental Abruption Is a Bleeding Emergency. Every Minute the Medical Team Delays Is a Minute the Baby Goes Without Oxygen.
Placental abruption occurs when the placenta, the baby’s lifeline for oxygen and nutrients, partially or completely separates from the uterine wall before delivery. When a significant abruption occurs, blood flow to the baby is severely compromised. Fetal distress develops rapidly, and without emergency intervention, oxygen deprivation can cause permanent brain injury, hypoxic-ischemic encephalopathy (HIE), or fetal death within minutes. Placental abruption is the leading cause of perinatal mortality in the developed world that is amenable to medical intervention.
The critical issue in most abruption-related birth injury cases is not the occurrence of the abruption itself, which may be unpredictable, but the speed and quality of the medical response once symptoms appear. Vaginal bleeding, severe abdominal pain, uterine rigidity or tenderness, and a suddenly non-reassuring fetal heart rate pattern are the hallmark warning signs. When these signs are documented in the medical record, and the team’s response is delayed, inadequate, or disorganized, preventable harm may result.
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Specific Failures That Support a Legal Claim
- Failure to recognize the classic clinical presentation of abruption, bleeding, pain, uterine tenderness, and deteriorating fetal status, and respond with appropriate urgency
- Delay in calling the attending obstetrician or activating an emergency delivery protocol
- Delay in performing an emergency C-section when the fetal heart rate pattern shows severe, prolonged decelerations or terminal bradycardia
- Continuing to wait when the clinical picture demands immediate action, treating an abruption as a “watchful waiting” situation when it has become hemodynamically significant
- Failure to manage maternal hemorrhage aggressively, including blood product administration and activation of the massive transfusion protocol
- Poor communication and handoff between nursing, resident, and attending staff delay the emergency response
Brain Injury Caused by Placental Abruption
When abruption causes even a few minutes of severe fetal bradycardia or loss of the fetal heart rate pattern, the baby’s brain can suffer hypoxic-ischemic injury. The severity of the injury depends on the duration and depth of oxygen deprivation. In the worst cases, the baby is delivered near-death with Apgar scores of 0-3, markedly acidotic cord blood gases (pH below 7.0), and MRI findings confirming diffuse brain injury. In moderate cases, the baby may appear to recover initially but later develop cerebral palsy, seizure disorders, or developmental disability. Both presentations, immediate catastrophe and delayed manifestation, can be legally significant.
Frequently Asked Questions
What causes a birth injury?
Birth injuries can occur for a number of different reasons. In some cases the child’s head is too large to fit through the mother’s pelvis. Other times the placenta become detached prematurely or the umbilical cord is compressed or twisted. Also, when a physician uses forceps or a vacuum during a vaginal birth, injury to the brain can result. In many of these instances time is of the essence. The doctor is responsible for knowing when a cesarean section is necessary in order to avoid injury to the child.
There is no way to completely eliminate the risk of birth injury, but some risk factors that can lead to trouble during child birth are drawn out labor, atypical positioning of the baby, too much Pitocin given to the mother, larger than average sized baby, premature birth and the use of forceps or vacuum.
Expectant parents tend to anticipate a relatively smooth birth process and a healthy baby. In the majority of cases this will be the outcome. Sadly, there are some instances where birth injury and possible lasting effects will result. If you or a loved one has a child affected by a condition that was caused by birth injury and you believe it resulted from negligence on the part of the medical staff, we can offer a free assessment of your case. We have extensive knowledge in the areas of birth injuries and medical malpractice, and will be happy to advise you of your options moving forward.
What is birth injury malpractice?
Medical malpractice relates to birth injury in cases where the medical professional charged with you and your baby’s care fails to provide appropriate care during pregnancy, during the delivery process, or shortly after the child is born.
To better understand birth injuries and how they can be caused by medical and/or nursing mistakes, first you need to understand the concept of medical malpractice. The following will explain what medical malpractice means, statistics and some general tips for selecting the right doctor and avoiding medical mistakes.
A birth injury is an injury that can happen prior to birth, during the labor and delivery process, or in the neonatal or “newborn” period. Injuries that occur during the prenatal period can be attributed to untreated infection such as Group B Streptoccoccus, placental insufficiency or abruption, and preterm birth causing respiratory distress and brain hemorrhage.
Labor and delivery injuries can be caused from a health care provider failing to recognize fetal distress during labor signaling decreased oxygen being delivered to the baby’s brain resulting in injuries to brain structures responsible for movement, cognition, vision, swallowing, and coordination. Additional injuries that occur during labor and delivery can be related to CPD or “cephalo-pelvic disproportion” whereby the baby’s head is too large to fit through the mother’s pelvis during the birthing process.
Did you know?
Rasansky | McKenzie Law negotiated a settlement of more than $10 million on behalf of an infant who was diagnosed with cerebral palsy as a result of medical and nursing malpractice. We have also obtained numerous multi-million dollar settlements for children who suffered other types of birth injuries caused by medical malpractice.
What should I do if my child suffered a birth injury?
The first and most important issue to deal with after a birth injury is caring for the health of the baby and the mother. Get advice, treatment, and support from medical professionals you trust, and do not be afraid to get a second opinion. Also, be sure to take advantage of counseling and therapy options if you or your family needs help processing what happened.
After the health and well-being of your family is under control, you may wish to speak with a Dallas birth injury lawyer. A medical malpractice attorney can help you better understand what caused your baby’s injury, collect the evidence of the case, and enumerate your legal options if you choose to take action.
A birth injury is traumatic for the entire family – and one mistake in labor and delivery can lead to a lifetime of medical costs, nursing care, disability, and therapy. If you believe that your child’s injury was caused by negligence, you owe it to your family to ensure that the person or hospital responsible for your child’s injury pays for the consequences of their negligent actions. If someone else caused the injury, why should the financial burden be placed on your family?
Is my child entitled to compensation?
Typically, it is not the parent but the child who will be awarded compensation, as it was the child who was injured by the doctor’s negligence making the child entitled to compensation. If you win your birth injury claim/lawsuit against the doctor/hospital, compensation is usually delivered in the form of a trust. Keep in mind though that parents can sue for emotional distress—or if the mother was also injured because of the doctor’s behavior. If the child dies because of a doctor’s negligence, the compensation goes to the parents.
What are the main types of birth injuries?
There are many types of injuries that can occur during pregnancy and delivery, ranging from minor to severe. Among the most common types of birth injuries are:
- Cerebral palsy.
- Brachial plexus injuries (Erb’s palsy, Klumpke’s palsy).
- Infections (B strep, meningitis).
- Baby brain damage.
- Bruising and bleeding beneath the cranial bones.
- Bone fractures and nerve damage (often to the upper arm).
- Shoulder dystocia.
- Spina bifida.
- Folic acid deficiency, anemia.
- Persistent Pulmonary Hypertension.
- Blood flow and/or oxygen being cut off to the baby during delivery (causing anoxic brain injury, hypoxia, birth asphyxia, or perinatal asphyxia).
- Wrongful death.
Will my child's birth injury go away?
Birth injuries do not always lead to serious and lasting harm to the child. Many of them will heal on their own with no medical intervention. In some incidences, however, birth injuries result in chronic conditions such as cerebral palsy, Erb’s palsy, or Klumpke’s palsy.
Of these, cerebral palsy is probably the most concerning, as the others do sometimes improve or resolve. Cerebral palsy can affect coordination, reflexes, gait, muscle tone, and mental capabilities. In a study among six countries, the incidence of cerebral palsy was estimated to be between 2.12 – 2.45 cases per 1000 births.
If you’re concerned whether or not your child’s injuries will improve, the best course of action is to speak to your pediatrician. If you’d like to have an attorney look into the facts of your case, call us at (214) 651-6100.
Placental Abruption FAQs
Is a placental abruption always an emergency?
The severity of abruption ranges from minor to catastrophic. A minor, self-limiting abruption with a reassuring fetal heart rate may be managed expectantly. A major abruption causing significant fetal distress is an obstetric emergency requiring immediate delivery. The standard of care requires the team to continuously reassess and escalate the response as the clinical picture evolves.
How fast should an emergency C-section be performed for placental abruption?
The standard in emergency obstetrics is a decision-to-incision interval of 30 minutes or less for a stat C-section, though in true catastrophic emergencies, even 30 minutes may be too long. When abruption causes terminal fetal bradycardia, the goal is delivery in minutes, not half an hour. In litigation, the actual decision-to-incision time documented in the operative record is compared against published standards and against the clinical urgency evident from the fetal monitoring strip.
Can the mother also have a claim if she was harmed by a placental abruption?
Yes. Maternal harm from placental abruption, including hemorrhagic shock, hysterectomy necessitated by uncontrolled bleeding, ICU admission, and, in fatal cases, death, can support both a personal injury claim for the mother and a survival action or wrongful death claim for surviving family members. Texas law allows both maternal and neonatal claims arising from the same obstetric event.
If your baby was injured or died because of a placental abruption that was not managed with appropriate urgency, the expert Dallas birth injury lawyers at Rasansky | McKenzie Law want to review your case. Free consultation, contingency fee, you owe nothing unless we win.
