3 Most Dangerous Delivery Complications
Guiding a mother through a successful labor and delivery can be like navigating through a minefield. Although the majority of deliveries result in the birth of a healthy baby, there are a host of things that can potentially go wrong at any time. The primary role of the OB/GYN and the hospital staff is to identify these potential complications in advance and/or manage them effectively when they occur.
There are a number of well-documented obstetric complications or events that are known to occur in a certain percentage of pregnancies. Some of these complications are easy for doctors to manage without any real threat to baby or mother. However, there are certain childbirth complications that present very real danger to the baby when they occur. Below is a list of the top 3 most dangerous complications that can occur during childbirth or pregnancy and list of recent malpractice verdicts and reported settlements involving each complication.#1 Umbilical Cord Prolapse
At the top of our list of the most dangerous childbirth complications is umbilical prolapse. A prolapsed umbilical cord is a dangerous complication that occurs when the umbilical cord drops down into the birth canal in front of the baby's head. The umbilical cord is essentially the baby's lifeline to the mother and it is critically important until the baby starts breathing on its own.
In a normal childbirth, the baby enters and passes through the birth canal first and drags the umbilical cord and placenta behind. When the umbilical cord prolapses or drops down into the cervix ahead of the baby it creates a very dangerous situation. As the baby pushes through the birth canal the prolapsed cord will get pinched or compressed by the head or shoulders. This type of compression of the vital umbilical cord severely restricts or even completely cuts off maternal oxygen supply. The baby effectively suffocates itself as it pushes through the birth canal.
The extreme danger presented by prolapse of the umbilical cord is clearly evident in the statistics. Umbilical cord prolapse has a perinatal fatality rate close to 50%. What makes umbilical cord prolapse so uniquely dangerous is that it occurs spontaneously and without warning. It is also one of the few complications which can completely cut off maternal oxygen delivery. When umbilical cord prolapse occurs doctors and nurses may only have a few minutes to intervene.Umbilical Prolapse Verdicts & Settlements
- Delgado v USA (Florida 2016) $2 million: during vaginal delivery of baby in footling breech position umbilical cord prolapses and gets compressed resulting in oxygen deprivation during birth. Baby is eventually diagnosed with cerebral palsy as a result of the hypoxic brain injury from the cord compression. His mother sues the federal hospital alleging that doctors should not have attempted vaginal delivery in light of breech presentation and that they were negligent in failing to promptly respond with an emergency C-section when cord prolapse occurred. Case settles prior to trial for $2 million.
- Plaintiff v Hospital (North Carolina 2013) $10 million: mother is admitted for delivery of twins. First twin is delivered without problem but the second twin develops prolapsed umbilical cord requiring emergency intervention. Doctor in charge of delivery fails to understand the gravity of the situation and does not order emergency C-section. Instead she continues with vaginal delivery efforts until more experienced doctor got involved and performed immediate C-section. Baby suffers severe oxygen deprivation and is diagnosed with very serious type of cerebral palsy requiring 24 nursing care and support. Case settles a week before trial for $10 million.
Our second most hazardous pregnancy and childbirth complication is uterine rupture. Uterine rupture is a rare complication which occurs when the mother's uterus wall suddenly ruptures or tears open. A severe uterine rupture can literally leave a gaping hole in the womb for the baby and amniotic fluid to come right out.
The characteristics that make uterine rupture such a particularly dangerous event are similar to umbilical prolapse. Uterine ruptures occur very suddenly and doctors have no way of predicting them in advance. Once the rupture does occur it creates an immediate emergency and a C-section must be performed to prevent any harm to the baby. Depending on the severity of the uterine tear doctors may have as little as 15 minutes to deliver the baby surgically. Even with a less severe tear the maximum window of time for safely delivering the baby once uterine rupture occurs is about 35 minutes.
Although uterine ruptures occur without warning, medical negligence can and often is a contributing factor in their occurrence mainly because of the known link between ruptures and VBACs. VBAC stands for vaginal birth after C-section. Once a woman has a C-section the scar tissue on her uterus from that procedure is weaker and more likely to rupture in a subsequent vaginal delivery.Uterine Rupture Verdicts & Settlements
- Blevins v Holzhauer (Mississippi 2018) $2.4 million: OB/GYN negligently mishandles delivery in several ways including starting an induction too soon, having the mother push before she was fully dilated and failing to intervene with a C-section soon enough. All of this allegedly increases pressure on the uterus and leads to a uterine rupture which the doctor negligently fails to timely identify. Although baby is safely delivered by C-section, the mother suffers numerous injuries requiring several corrective surgeries. Jury in Columbus County finds 9-3 in favor of plaintiff and awards $2.4 million.
- Plaintiff v OB/GYN (Massachusetts 2018) $5 million: mother is admitted to hospital for VBAC attempt on 2nd child. She is put on Pitocin drip to induce and speed up labor. Several hours in the electronic fetal monitoring strips begin showing Category II warnings of fetal stress and the mother also reports severe pain. Doctor dismisses the EFM warnings and continues the Pitocin. Uterus ruptures severely at site of prior C-section scarring and baby's leg is sticking out of the womb on delivery. Baby suffers hypoxic ischemic encephalopathy (HIE) and is eventually diagnosed with cerebral palsy and mother is forced to have emergency hysterectomy. She sues doctor and nurse and the case is settled out of court for $5 million.
The last entry on our list of the most dangerous childbirth complications is shoulder dystocia. Shoulder dystocia occurs when the baby's head enters the birth canal but one of their shoulders becomes stuck on the mother's pelvis. When shoulder dystocia occurs during delivery it creates a delivery room emergency. If doctors and hospital staff cannot free the stuck shoulder quickly the baby may be at risk for oxygen deprivation and serious brain injury.
There are number of long-standing obstetric maneuvers that doctors and delivery room nurses are trained to employ in response to shoulder dystocia. The aim of these maneuvers is to quickly dislodge the trapped shoulder and deliver the baby to safety without harm. However, to be effective these maneuvers require skill, experience and a lot of patience under pressure. The problem is that too many doctors tend to panic when confronted with shoulder dystocia. They rush through the obstetric maneuvers without success and end up using forceps to vacuum extractors to forcibly manipulate the baby through the birth canal.Shoulder Dystocia Verdicts & Settlements
- Plaintiff v OB/GYN (Virginia 2019) $1.1 million: defendant obstetrician with little experience, encounters shoulder dystocia during plaintiff's delivery. He attempts to perform various obstetric maneuvers to free the shoulder but allegedly performs the techniques incorrectly and ends up injuring the baby. Baby suffers severe damage to brachial plexus nerve from excessive lateral traction force resulting in total avulsion of nerves. Attempts to surgically repair the damaged nerves are not successful and mother sues on behalf of infant son. Case is settled out of court for $1.1 million.
- Edwards v Depani-Sparkes (Oaklahoma 2018) $700,000: doctors in this case fail to diagnose fetal macrosomia in advance and when they attempt vaginal delivery of large baby shoulder dystocia is encountered. Doctors and hospital staff completely botch the dystocia maneuvers and end up damaging the baby's brachial plexus nerves in the process of dislodging the shoulder. Baby is diagnosed with Erb's palsy and mother sues for negligent failure to diagnose macrosomia and negligent management of delivery. Jury in Oklahoma City awards plaintiff $700,000.
If your child was injured during birth it may have been the result of medical negligence or error. Contact the birth injury attorneys at Miller & Zois to find out if a mistake was made and if you may be entitled to compensation. Call us at 800-553-8082 or get a free online consultation today.