Obstetrical emergencies are life-threatening medical conditions that occur in pregnancy particularly during or shortly after labor and delivery.
Any medical procedure is fraught with potential dangers but these can be compounded by obstetric malpractice or negligence due to simple human errors causing medical mistakes. As a lawyer we need to establish on the balance of probabilities, that is more than 50%, that the medical gynaecologist or obstetric specialist acted in a manner that was careless, out of line with medical peer group or neglectful causing damages to either or both the mother of the newly born child or the newborn.
The most common reasons for gynaecological and obstetric negligence/hospital claims relates to brain damage known as neurological impairment (about 30%), stillbirth (14%), delay in diagnosis or failure to diagnose (11%). Gerard Malouf and Partners compensation and medical lawyers are experts at assisting victims of medical malpractice and medical mistakes to obtain justice and maximum compensation having run thousands of medical negligence cases involving hospitals, nurses, medical specialists, general practitioners and other medical contractors.
Obstetricians and gynaecologists are likely to be involved in a medical malpractice negligence case because of a few simple reasons: –
Examples of areas of obstetric practice that can develop into emergencies due to medical malpractice/negligence:-
An ectopic, or tubal, pregnancy occurs when the fertilized egg implants itself in the fallopian tube rather than the uterine wall. If the pregnancy is not terminated at an early stage, the fallopian tube will rupture, causing internal hemorrhaging and potentially resulting in permanent infertility due to loss of the fallopian tube.
Also called abruptio placenta, placental abruption occurs when the placenta separates from the uterus prematurely, causing bleeding and contractions. If over 50% of the placenta separates, both the fetus and mother are at risk. This needs to be picked up immediately by the obstetrician.
When the placenta attaches to the mouth of the uterus and partially or completely blocks the cervix, the position is termed placenta previa (or low-lying placenta). Placenta previa can result in premature bleeding and possible postpartum hemorrhage. The unborn child suffers stress. Fetal monitoring is critical.
Preeclampsia (toxemia), or pregnancy-induced high blood pressure, causes severe edema (swelling due to water retention) and can impair kidney and liver function. The condition occurs in approximately 5% of all United States pregnancies. If it progresses to eclampsia, toxemia is potentially fatal for mother and child.
PREMATURE RUPTURE OF MEMBRANES (PROM)
Premature rupture of membranes is the breaking of the bag of waters (amniotic fluid) before contractions or labor begins. The situation is only considered an emergency if the break occurs before thirty-seven weeks and results in significant leakage of amniotic fluid and/or infection of the amniotic sac.
AMNIOTIC FLUID EMBOLISM
A rare but frequently fatal complication of labor, this condition occurs when amniotic fluid embolizes from the amniotic sac and through the veins of the uterus and into the circulatory system of the mother. The fetal cells present in the fluid then block or clog the pulmonary artery, resulting in heart attack. This complication can also happen during pregnancy, but usually occurs in the presence of strong contractions.
INVERSION OR RUPTURE OF UTERUS
During labor, a weak spot in the uterus (such as a scar or a uterine wall that is thinned by a multiple pregnancy) may tear, resulting in a uterine rupture. In certain circumstances, a portion of the placenta may stay attached to the wall and will pull the uterus out with it during delivery. This is called uterine inversion.
Placenta accreta occurs when the placenta is implanted too deeply into the uterine wall, and will not detach during the late stages of childbirth, resulting in uncontrolled bleeding.
PROLAPSED UMBILICAL CORD
A prolapse of the umbilical cord occurs when the cord is pushed down into the cervix or vagina. If the cord becomes compressed, the oxygen supply to the fetus could be diminished, resulting in brain damage or possible death.
Shoulder dystocia occurs when the baby’s shoulder(s) becomes wedged in the birth canal after the head has been delivered. Careful and immediate use of forceps is required. However, many of these complications can be anticipated via an experienced practitioner and avoided.
BRAIN INJURY AND BIRTH DEFECTS
As a result of poor obstetric and gynaecological treatment brain injury and multiple birth defects resulting in loss of oxygen to the unborn child can occur. If the unborn child experiences foetal distress and this is not monitored appropriately by hospital staff and/or the obstetrician and goes undetected even for a short period of time, perhaps only 10 to 20 minutes, significant you irrepairable brain damage can occur. The side-effects would likely result in permanent loss of speech, partial or total paralysis of the nervous system, greatly reduced brain and cognitive functioning. Whilst the child may survive birth the impact on the family and parents is devastating because of the immense home care, maintenance and financial burden required to raise a brain injured child with multiple birth defects.
POSTPARTUM HEMORRHAGE OR INFECTION
Severe bleeding or uterine infection occurring after delivery is a serious, potentially fatal situation. This needs to be monitored and treated quickly often with strong intravenous drugs.
Many of the above complications can be avoided by careful fetal monitoring, pelvimitary investigations, reviewing previous birth histories, monitoring of blood samples and pressure, quick and immediate reactions to developing medical conditions.