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Medical Malpractice During Pregnancy

Medical malpractice during your pregnancy or during the birth of your baby can lead to the death or serious injury of your baby.  If your baby was stillborn, died at birth, or suffered a serious injury during the birthing process, you will need to find out whether your baby's death or serious injury was the result of medical malpractice.  To help you begin to answer this question, this article describes some of the most common forms of medical malpractice that happen in the setting of pregnancy.

Medical Malpractice During Pregnancy:

  • Failure to deliver your baby on time.  According to the leading medical literature, your unborn baby's risk of serious injury or death increases with each day your baby remains in the womb past your due date.  There are several reasons for this.  Your baby continues to grow inside the womb and larger babies are more difficult to deliver vaginally.  After your due date passes you may not have adequate amniotic fluid to accommodate your growing baby.  Also, your baby's risk of intra-uterine infection grows when you pass your due date.  There is also an increased risk that your post-date baby will become tangled in the umbilical cord (umbilical cord entrapment).  In addition, the risks of meconium aspiration and placental insufficiency grow when your baby remains in the womb after your due date.  The careful doctor will closely monitor your condition and the condition of your unborn baby after your due date, and will not permit you to go more than two weeks past your due date without inducing labor or offering you a C-section.
  • Failure to diagnose and treat your placenta previa.  Your placenta should be positioned relatively high in the uterus, either on the front or back wall, far away from the cervix.  A abnormal condition called placenta previa occurs when the placenta attaches itself near to or overtop of the cervix.  Placenta previa greatly increases the risk of maternal and fetal injury and death.  A prenatal ultrasound is used to diagnose placenta previa.  Once a diagnosis of placenta previa is made, your pregnancy must be treated as high risk.  Depending on the degree of previa, and your stage at the time of diagnosis, your baby may need to be delivered early or you may need to be hospitalized for the remainder of your pregnancy.
  • Failure to diagnose and treat your placental abruption.  Another placental abnormality is called placental abruption.  Placental abruption occurs when the placenta, or a part of the placenta, separates from the wall of the uterus prior to the birth of your baby.  This can result in severe, uncontrollable maternal bleeding and fetal death.  As with placenta previa, placental abruption is diagnosed with ultrasound.  Once a diagnosis of placenta previa is made, your pregnancy must be treated as high risk.  Depending on the degree of abruption and your stage at the time of diagnosis, your baby may need to be delivered early or you may need to be hospitalized for the remainder of your pregnancy.
  • Failure to respond appropriately to your reports of vaginal bleeding.  Though "spotting" during your pregnancy may be normal, you are not supposed to experience true vaginal bleeding, particularly during your second and third trimesters.  Vaginal bleeding in the second or third trimester can be a sign of a serious condition such as pre-term labor, placenta previa or placental abruption.  Even first trimester bleeding may be a sign of an underlying problem with the placenta.  If you report vaginal bleeding during your second or third trimester and nothing is done about it, medical malpractice is probably present.
  • Failure to diagnose larger and smaller than normal fetus and anticipate resulting birth risks and complications.  It is generally recognized that larger babies, particularly babies over 4000 grams (8.8 pounds), are at increased risk of injury during vaginal birth.  Similarly, premature babies (those born before 37 weeks) are also more vulnerable to birth injury. Ultrasound and measurements of uterine size are used to calculate the size of the fetus.  While these calculations are not 100% accurate, they do adequately approximate fetal size to enable the doctor to identify most larger- and smaller-than-normal fetuses.
  • Failure to diagnose and treat gestational diabetes.  Gestational diabetes occurs when pregnancy hormones interfere with the body's ability to use insulin, the hormone that turns blood sugar into energy, resulting in high blood sugar levels.  Your doctor should screen you for gestational diabetes between your 24th and 28th weeks of pregnancy, or earlier on in your pregnancy if you have certain risk factors, such as gestational diabetes in a prior pregnancy, obesity, a family history of diabetes, or a prior birth of a very large (over 9 pounds) baby.  If not diagnosed and treated, gestational diabetes can significantly increase the risk of birth-related injury to both the fetus and the mother.
  • Failure to diagnose and manage preeclampsia.  Preeclampsia is a pregnancy-related condition characterized by high blood pressure and the presence of protein in the blood.  Preeclampsia typically occurs after 20 weeks of gestation, though it can occur earlier.  As with gestational diabetes, proper prenatal care is essential to diagnose and manage preeclampsia.  Preeclampsia is more common in women who have preexisting hypertension, diabetes, and in women with a multiple gestation (twins, e.g.). The single most significant risk for developing preeclampsia is having had preeclampsia in a previous pregnancy.  The only cure for preeclampsia is C-section or induction of labor.  However, management of preeclampsia may include blood pressure medications, corticosteroids, anticonvulsive medications, and bed rest.  If not diagnosed and properly managed, preeclampsia can lead to dangerous seizures, placental abruption, stroke and possibly severe bleeding.     
  • Failure to properly manage your post C-section pregnancy.  If you have already had a C-section and become pregnant again, you have an increased risk of uterine rupture during labor if you deliver vaginally.  Uterine rupture during labor is a medical emergency that can only be handled in a hospital capable of performing emergency C-sections.  The risk of "VBAC" (vaginal birth after C-section)-related uterine rupture increases significantly if you have two C-section scars and have not delivered vaginally before, or if you have any scarring above the lower, thinner part of your uterus.  Risk of uterine rupture also increases significantly if labor needs to be induced with medicine.
  • Failure to diagnose and treat pre-term labor.  Labor that occurs before the 37th week of pregnancy is referred to as "preterm labor."  Babies delivered pre-term are at significantly increased risk of neurological, breathing, digestive and other long-term health problems, and death.  Symptoms of pre-term labor include contractions every 10 minutes or more often; change in vaginal discharge; pelvic pressure—the feeling that your baby is pushing down; low, dull backache; cramps that feel like menstrual cramps; and abdominal cramps with or without diarrhea.  There are treatments and medications that can help to stop preterm labor if they are given early enough.  To try to stop preterm labor, you may be treated with a tocolytic such as magnesium sulfate.  A Tocolytic will slow contractions of the uterus.  By delaying preterm labor, doctors can use other medications to help speed up the baby's lung development and improve the baby's chance of survival.  Medical malpractice occurs when your doctor fails to diagnose and treat your pre-term labor.
  • Failure to diagnose and/or manage fetal distress.  During your pregnancy, your unborn baby may develop something called fetal distress.  Fetal distress is caused by a lack of oxygen getting to your baby in utero.  There are many reasons your unborn baby may not be getting an adequate flow of oxygen, including pressure on the umbilical cord, pressure on one or more of your blood vessels that provide oxygenated blood to the fetus, inadequate amniotic fluid levels, and any number of problems with your placenta.  The risk of fetal distress increases significantly as you pass your due date.  Fetal distress during your pregnancy may manifest itself in diminished fetal movement.  Fetal distress during your pregnancy is diagnosed using a test called a Non-Stress Test.  During this test, the fetus's heart rate is monitored with an electronic fetal monitor while you identify fetal movements by raising your hand each time your baby moves inside your uterus.  The baby's heart rate should briefly accelerate with each fetal movement and then return to baseline.  If the Non-Stress Test fails to reassure, your doctor should then order an ultrasound and a biophysical profile.  The biophysical profile measures your baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around your baby.     If failure to diagnose and properly manage fetal distress can lead to serious injury or death.   

These are some of the most frequently-occurring forms of medical malpractice during pregnancy.  If any of these examples sound similar to what you went through, you should contact a law firm experienced in handling cases of pregnancy-related medical malpractice.  Berger & Lagnese has a long and successful record of handling cases of pregnancy-related medical malpractice.

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