When the Placenta Fails to Do Its Job, and the Medical Team Fails to Respond
Placental insufficiency, also called uteroplacental insufficiency (UPI), occurs when the placenta cannot deliver adequate oxygen and nutrients to the fetus. The result is impaired fetal growth (intrauterine growth restriction, or IUGR), decreased fetal movement, abnormal antenatal testing, and, as the condition worsens, fetal compromise that requires timely delivery to prevent fetal brain injury or stillbirth. Placental insufficiency is one of the most identifiable and manageable high-risk obstetric conditions; it is detectable through prenatal surveillance and manageable through appropriately timed delivery.
When a pregnancy complicated by placental insufficiency is not adequately monitored, when warning signs on antenatal testing are ignored, or when delivery is delayed after clear signs of fetal compromise appear, the resulting birth injury may be legally attributable to the care team’s failure to act on what the evidence was telling them.
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The Surveillance Tools That Should Detect Placental Insufficiency
A properly monitored high-risk pregnancy with suspected uteroplacental insufficiency should involve: serial growth ultrasounds to track fetal weight and interval growth; umbilical artery Doppler flow studies, which can demonstrate increasing placental resistance as insufficiency worsens; amniotic fluid index measurements; biophysical profile (BPP) assessments; and non-stress testing (NST) to assess fetal heart rate reactivity. The progression from normal to abnormal findings on these tests defines the urgency of the clinical response, up to and including immediate delivery.
When Delay in Delivery Causes Brain Injury or Stillbirth
A baby who has been growth-restricted and chronically oxygen-deprived due to placental insufficiency has reduced physiological reserve going into labor. When delivery is delayed beyond the point at which the fetal testing indicates compromise, or when an already-compromised baby is then subjected to the further oxygen demand of labor contractions, the combination can be lethal or permanently injurious. Stillbirth from placental insufficiency, when abnormal testing was present days or weeks before the fetal death, is one of the most preventable pregnancy losses. Similarly, a baby born after prolonged placental insufficiency with signs of in utero compromise may develop Hypoxic Ischemic Encephalopathy (HIE), cerebral palsy, or neurodevelopmental disorders that trace directly back to inadequate surveillance and late delivery.
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 Insufficiency FAQs
What is the difference between IUGR and placental insufficiency?
Intrauterine growth restriction (IUGR) describes the observed consequence, the baby is smaller than expected for gestational age. Placental insufficiency describes the mechanism in which the placenta is not delivering adequate nutrients and oxygen. Not all IUGR is caused by placental insufficiency (constitutional smallness, genetic conditions, and infections can also cause IUGR), but placental insufficiency is the most common cause of pathological growth restriction in developed countries.
If the baby was alive but small at delivery, can there still be a case?
Yes. A baby who survives but sustains brain injury due to chronic hypoxia from placental insufficiency, manifesting as cerebral palsy, intellectual disability, or developmental delay, may have a viable legal claim, even if the birth itself did not appear catastrophic. The damage in these cases often accrues over weeks or months of inadequate oxygenation, and the failure is not a single event but a prolonged period of inadequate surveillance and delayed decision-making regarding delivery.
If your baby was diagnosed with brain injury, cerebral palsy, or was stillborn after a pregnancy complicated by poor fetal growth or abnormal testing, our award-winning Texas birth injury attorneys at Rasansky McKenzie Law can review the prenatal records and explain what they reveal. Free consultation.
