A placental abruption is a serious complication that can arise late in pregnancy and can cause serious injury to the baby or even result in a stillbirth. In certain cases it can also lead to the death of the mother. There is no treatment for a placental abruption. When an expectant mother presents with symptoms that are consistent with a placental abruption, physicians and nurses must either rule out the possibility of a placental abruption or take action immediately in order to protect the baby and the mother.
A placental abruption is often accompanied by heavy vaginal bleeding and by pain in the lower back and abdomen. Depending on where and how much of the placenta separates from the uterus, however, there may be no visible bleeding. Other symptoms that may indicate a placental abruption include a drop in the fetal heart rate as the unborn baby is deprived of oxygen, a change in blood pressure, and unusual contraction patterns. The following cases illustrate how physicians and nurses sometimes miss these symptoms
In the 1st reported case an expectant mother who at age 38 went to see her obstetrician with persistent vaginal bleeding accompanied by back and abdominal pain. She was sent home. The next day she went to the hospital due to massive vaginal bleeding. The physician at the hospital interpreted the readings from the fetal heart rate monitor as reassuring. The physician concluded that labor had not yet commenced. Without conducting a full workup for the bleeding and the pain and without ordering an ultrasound the physician and sent her home even though she continued to complain of vaginal bleeding accompanied by abdominal pain. Her symptoms had been caused by a placental abruption. The baby was later born still. The law firm that handled this matter reported that the case went to trial with a resulting verdict of $1,651,166.
While at the hospital she was connected to a fetal heart rate monitor which the hospital physician read as normal. Again, a physician decided that it was not necessary to conduct a full workup to determine the cause of the bleeding. Without as much as ordering an ultrasound, the hospital physician reached the conclusion that the woman was not in labor yet and sent her home even though she was still complaining that she was continuing to bleed and still had abdominal pain. During delivery it was determined that the cause of the bleeding and pain had been a placental abruption. The law firm that handled this case reported that they took the case to trial where a jury returned a verdict of $1.65 million to the mother.
In the 2nd reported case the baby was also born still. The expectant mother went to the hospital to deliver her baby. She was admitted and examined. The examination revealed that her blood pressure was elevated. This should have prompted close monitoring of her blood pressure throughout the remainder of labor. But no other readings were taken. The nurse in charge later documented in the chart that the expectant mother was having a contraction pattern that was unusual. The nurse did not consider the combination of these two signs as suggestive of a potential placental abruption. The nurse therefore took no steps to protect the baby, did not attempt to resuscitate the baby, and did not notify a physician of the developments. The law firm that represented the mother was able to report a settlement in the amount of $300,000.
An analysis of the two cases reveals the following: In the 1st case, the expectant mother showed 2 main signs of experiencing a placental abruption. Indeed, one of the signs, vaginal bleeding, was described in her chart as "massive" bleeding. Still, the physician appears to have considered only the results of the fetal heart rate monitor. The physician appears not to have considered the risk of a placental abruption, the possible harm to the baby, or even to the expectant mother who could go into shock from so much blood loss.
In the 2nd case, the expectant mother did not experience any bleeding that could be seen. She did, nonetheless, have an elevated blood pressure. She also had unusual patterns of contraction. These signs alone suggest the possibility of a complication and merit close monitoring. There is no mention of the readings from the fetal heart rate monitor which might also have been a sign of a developing emergency complication. Having been left alone to monitor the expectant mother the nurse did not inform the physician of these issues and made no effort at resuscitating or otherwise trying to protect the health of the unborn baby.
If a physician or nurse does not realize that a complication has developed in the pregnancy they will not take the action necessary to resolve the complication while protecting the health of the unborn baby and the expectant mother. Depending on the nature of the complication and its degree of severity this could result in a serious injury, or even death, to the baby or mother. In the cases examined above the failure to act in the presence of a placental abruption the baby was dead on delivery. The physicians and nurses involved either settled or were found liable by a jury.
Author Resource:-
Joseph Hernandez is an Attorney focused on birth injury cases, including birth injury cases. You can learn more about placental abruption and other birth injury cases at his website www.birth-injury-malpractice-law.com
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