Medical Malpractice
Placental abruption (or “abruptio placentae” or accidental hemorrhage) is a premature separation of the placenta. A partial placental abruption is where a portion of the placenta detaches from the uterus. It begins with bleeding underneath the placenta. The real issue that’s very difficult to determine is what actually causes the bleeding to occur.
Placental abruption is most common during the third trimester of pregnancy, but it can occur as early as 20 weeks. When a placenta ruptures, the connection with the fetus is broken, depriving the fetus of essential nutrients and oxygen, its waste disposal system and its protection against infection.
This can cause distress for the mother and birth injuries or death to the child. Placenta previa is sometimes confused with placental abruption; however, they are distinct conditions. With placenta previa, the placenta partially or entirely covers the cervix. The common thread is the concern about bleeding.
Our lawyers see cases where the doctors were negligent in failing to diagnose and treat a placental abruption. In many cases, an abruption necessitates emergency measures, typically an immediate cesarean delivery. The failure to diagnose a placental abruption and take immediate action can endanger both the mother and baby.
If you believe your child has birth injuries that may be from medical malpractice, call us today at 800-553-8082 or get a free, no-obligation case evaluation online.
- What is the settlement value of placental abruption cases?
What Causes Placental Abruption?
Sometimes we know the cause of the bleeding that causes an abruption. Placental abruptions are associated with trauma, particularly abdominal trauma. We also know that abruptions are associated with drug abuse, specifically smoking tobacco and cocaine.
There are also underlying medical ailments that can predispose a woman to an increased risk of placental abruption. These conditions include high blood pressure, diabetes, autoimmune diseases, like lupus or rheumatoid arthritis, that affect blood vessels. If the mother has these problems, doctors should have a heightened concern about the risk of an abruption.
Signs and Symptoms
The diagnosis of placental abruption is a clinical diagnosis. So you look at certain signs and symptoms from the mother like abdominal pain and, in particular, vaginal bleeding. You also look at the fetal heart strips for signs of fetal distress or a nonreassuring heart rate. If there is a concern, a sonogram is often a good place to start.
But they vary significantly. The symptoms may appear singly, in combination, or there may be no symptoms because the bleeding is hidden. Defense lawyers and their experts in these lawsuits say as many as 50% of placental abruptions have hidden bleeding. (This is almost certainly an exaggeration to make these abruptions seem impossible to predict or diagnose.)
The reason for an abruption without bleeding is that the bleeding is hidden because the blood insinuates itself between the membranes and uterus, and then escapes through the cervix, causing external hemorrhage. You do not see bleeding until the separation nears a complete level when there is no longer blockage of blood escape into the vagina.
Diagnosing a Placental Abruption
MRIs are highly sensitive in depicting placental abruption and may be considered if no ultrasound evidence of placental abruption is present. This is, of course, particularly true if the placental abruption would change the management of the patient. But the most practical and common method for imaging a placental abruption is an ultrasound without any radiation that would be harmful to the fetus.
But an ultrasound is not a perfect tool to diagnose a placental abruption. It will only see a placental abruption if the images show a significant clot underneath the placenta. A negative evaluation does not reliably exclude the presence of placental abruption.
Doctors need to be aware of this and not drop their guard when they have evidence of a possible abruption. Again, the confusion with placenta praevia comes into play here because you can rule out placenta praevia with an ultrasound, but you cannot diagnose an abruption with certainty.
Placental abruption is suspected when a pregnant mother has sudden localized abdominal pain with or without bleeding. The fundus may be monitored because a rising fundus can indicate bleeding.
Again, an ultrasound may be used to rule out placenta praevia but is not diagnostic for abruption. The diagnosis of abruption is often one of exclusion if imaging does not confirm an abruption. This means the doctor must consider other possible sources of vaginal bleeding or abdominal pain and rule them out to diagnose placental abruption.
The Degree of Abruption Matters
The placenta has an excess capacity to provide for the fetus. Even if 40 percent of the placenta is abrupted, the baby will still be fine and will continue to get the oxygen and nutrients it needs while continuing to serve as a waste disposal system. The key is whether the separation of the placenta stops there.
Once the diagnosis of placental abruption is made, the question is what to do. There are a number of management choices at this point, depending upon the degree of concern, which includes facilitating delivery to avoid more severe complications. Another less extreme option is bed rest.
Approximately 15% of severe placental abruption cases end in death.
Risk Factors and Warning Signs
Many medical malpractice cases stem doctors missing the warning signs of an abruption. While less than one percent of pregnant women suffer placental abruptions, including smokers, drug users, and diabetics, are at great risk, as are women over 40, carrying multiples, and women who have had several children in the past.
The standard of care requires that relevant risk factors be noted by the OB/GYN early in the pregnancy, along with the appropriate follow-up. In the case of an abruption, the standard of care dictates that the doctor recognizes these risk factors and orders the appropriate tests and follow-up to monitor the risk. If the OB/GYN fails to properly diagnose or treat abruption, it may cause harm to the mother and child, which may be medical malpractice.
Placental Abruption Birth Injury Verdicts & Settlements
2024, Georgia: $17,308,904 Verdict
Lawsuit claimed the defendant failed to diagnose ectopic pregnancy, which caused the mother to suffer a fatal placental abruption five months after her initial presentation. The plaintiff contended the defendant failed to take a proper medical history, retrieve prior ultrasounds, and utilize appropriate ultrasound techniques to diagnose and treat the decedent’s ectopic pregnancy. In addition, the plaintiff claimed the defendant failed to recognize the decedent’s continued complications and, after admitting her to the hospital, failed to properly examine her or manage her medical care.
2023, Maryland: $33,915,000 Verdict
A mother came to the hospital at 23 weeks gestation with abdominal cramping and brown discharge. The defendant OB/GYN negligently misdiagnosed her symptoms as placental abruption and ordered an emergency C-section. It turned out that a placental abruption had not occurred and the premature delivery was unnecessary. The baby was born with severe brain damage as a result.
2022, Pennsylvania: $629,843 Settlement
Lawsuit alleged that the mother presented to the defendants’ OB/GYN practice with clear symptoms of placental abruption, including abdominal pain, blood in urine, and vaginal bleeds, but that they negligently failed to diagnose her placental abruption and sent her home. As a result of this failure to diagnose, the baby died in the womb from oxygen loss.
2021, Georgia: $5,920,000 Verdict
The mother regularly had elevated blood pressure at all of her prenatal appointments, as well as swelling in her ankles and other signs that she was potentially at risk for placental abruption. The defendants opted not to induce and wait instead. Eventually, the woman went to the hospital with severe pelvic pain, and it was discovered that she had suffered a placental abruption. The baby was stillborn, and the mother filed a wrongful death lawsuit.
2017, California: $4,250,000 Settlement
Mother is admitted to the hospital for labor and delivery. Plaintiff is experiencing pain and bleeding consistent with, among other things, a placental abruption. After some period, an emergency cesarean section is performed. Plaintiffs filed a lawsuit alleging the doctors failed to timely diagnose and treat the placental abruption. They contend that the child’s hypoxic-ischemic encephalopathy, cerebral palsy, developmental delay and kidney damage is the result of the failure to diagnose the placental abruption and perform a C-section before the oxygen loss caused the child permanent brain damage.
2017, Pennsylvania: $14,448,000 Verdict
Plaintiff goes to the hospital to deliver her son. Defendants use Pitocin to begin her labor, despite her already being dilated. This violates hospital protocol due to the closeness of the contractions. Before the delivery, the baby exhibits signs of fetal distress but there is a delay in delivery. The oxygen lost during that delay changes the course of the child’s life. The boy is unable to care for himself and is unable to walk, sit up, or talk. It is just an unbelievable tragedy no matter how you slice it. The jury concludes the doctor and the hospital were responsible for the tragedy and awards $14,448,000.
2016, Pennsylvania: $1,800,000 Settlement
A mother arrives at the hospital to have her labor induced, and she is started on Pitocin. Pitocin doses are increased incrementally throughout the morning. After a few hours, she requests an epidural, but her membranes rupture. The Pitocin is stopped, but once the fetal heart tones become reassuring again, it is restarted. Six hours after her membranes ruptured, her labor has not progressed at all. The Pitocin is continued and changes are noted after. After two hours of pushing, decreased variability is discovered in the fetus, and a C-section becomes necessary. At birth, her infant has a high fever and is breathing rapidly. As a result of the delayed delivery, the baby suffers neurological injuries and global developmental delays. The mother hires a placental abruption lawyer and files the claim against the hospital, alleging negligence in failing to timely perform the C-section and in failing to realize that due to the Pitocin, the mother’s uterus was hyperstimulated. The defendants deny negligence but settle the claim for $1,800,000.
2015, New York: $52,681,017 Verdict
During labor, defendant doctors administer Pitocin. After they administer the drug, they fail to monitor the fetal heart rate and fail to respond to symptoms developing in the mother. As a result, the newborn suffers brain damage, cerebral palsy, blindness, global developmental delays, and motor delays. She is unable to live independently. The mother files a lawsuit on behalf of the child and wins $52,681,017.
2015, Florida: $18,270,052 Verdict
A mother is giving birth to her son at the hospital when the doctor mismanages her labor. The woman is given excessive doses of Pitocin, leading to a brain injury and cerebral palsy in the infant. The plaintiff is awarded $18,270,052.
2015, Illinois: $5,250,000 Settlement
A mother goes to the hospital to give birth to her son. She is given Pitocin, but the hospital fails to detect signs of fetal distress. As a result, her infant is born via an emergency C-section after he suffers from a lack of oxygen and brain damage. The boy’s parents file a claim on his behalf, which settles for $5,250,000.
2015, New York: $593,973 Settlement
An infant is born with nerve damage in her spine and Erb’s palsy of her right shoulder. During her birth, her mother is administered Pitocin when it is not indicated. Additionally, the doctors delay the performance of a C-section. The parties settle the case for $593,973.
2014, Kentucky: $18,270,052 Verdict
A mother goes to the hospital to have her baby. While there, she is given excessive doses of Pitocin, resulting in uterine tachysystole (six contractions in ten minutes). The nurses fail to report the fetal heart abnormalities to her OB/GYN, resulting in delayed medical intervention that would have prevented fetal distress. As a result of the excessive amount of Pitocin that was administered, the infant suffers a permanent brain injury resulting in cerebral palsy due to fetal distress. A jury finds the hospital to be 100% at fault, and awards the woman $18,270,052.37.
2014, New York: $2,700,000 Settlement
A 19-year-old mother is in labor. Pitocin is initiated. But the doctors fail to recognize the signs of fetal distress and therefore fail to stop the Pitocin. As a result, the child suffers a lack of oxygen to his brain and neurological injuries. The child later dies at just six years old. The plaintiff argues that the Pitocin should have been stopped during the second stage of labor due to excessive uterine activity. The case settles, including a wrongful death claim, before trial for $2,700,000.
2013, Pennsylvania: $55,000,000 Verdict
Plaintiff is having a slow labor progress despite the administration of Pitocin. Plaintiff argues that the large size of her baby poses a contraindication to a continued administration of Pitocin. Fetal monitoring shows concerning signs of fetal distress, but the labor is allowed to continue. The baby is born limp, blue, and is not breathing. He suffers a lack of oxygen before birth, causing cerebral palsy. Plaintiff argues a series of errors, including the failure to recognize fetal hypoxia and the failure to discontinue Pitocin when signs of strong contractions became apparent. A jury finds the OB/GYN was 50% negligent and the hospital was 50% negligent. They award the plaintiff $55,000,000.
2013, Oklahoma: $20,000 Settlement
Plaintiff receives prenatal and delivery services from an OB/GYN. A week before delivery, an ultrasound is done that estimates her fetus to weigh seven pounds and four ounces. While inducing delivery with Pitocin, the infant experiences shoulder dystocia. The doctors use force to combat this, which causes severe brachial plexus. The infant is left with permanent left shoulder and arm injuries requiring two surgeries. The plaintiff claims that the defendants were negligent in misinforming the doctors of the size of the infant and by improperly proceeding with a vaginal delivery. Additionally, they argue that the defendants should have never used Pitocin to induce the woman’s delivery. The parties settled for $20,000. This case is certainly the white elephant of these verdicts. It is hard to know what went wrong for plaintiffs in this case, but obviously, there must have been some extremely significant flaws in their case because this reads like a multi-million dollar case if the malpractice lawyers could make out a liability case.
2012, Illinois: $12,000,000 Settlement
A woman is admitted to the hospital for labor and delivery. Defendant OB/GYN orders Pitocin to induce labor, but fails to perform a Cesarean section when the baby exhibits signs of distress. The woman brings a complaint against the hospital, alleging the failure to monitor her labor, failure to recognize the fetus was in distress, and negligent administration of Pitocin during labor. The parties settle the case for $12 million.
2012, Ohio: $8,583,000 Verdict
Defendants administer Pitocin to a mother to induce her labor. This creates a stressful utero environment, causing significant stress to the infant. The infant is delivered in a floppy state and fails to receive adequate ventilation and oxygen immediately after her birth. She suffers a loss of oxygen, sequelae of right central seizure activity due to cerebral palsy, spastic quadriplegia, cortical visual impairment, and respiratory distress syndrome. The defendants dispute the claim denying the improper administration of Pitocin. A jury awards the plaintiff $8,583,000.
What are the Signs and Symptoms of Placental Abruption?
There are 3 primary symptoms that should indicate to doctors that the placenta has prematurely detached from the uterus wall (placental abruption):
- Significant contraction and then rising of the uterus
- Sudden lengthening of the umbilical cord
- Gush of blood
How Long Can a Baby Survive After a Placental Abruption?
Once a placental abruption begins, the countdown to a medical crisis is immediate and unforgiving. The placenta is the baby’s only source of oxygen and nutrients, and when it detaches from the uterine wall, that lifeline is compromised. Oxygen deprivation can begin almost instantly, and without swift medical intervention, the baby is at serious risk of brain injury or death. The exact time a baby can survive after an abruption depends on how much of the placenta separates and how quickly that separation progresses. In partial or less severe cases, there may be a brief window to stabilize and deliver safely. But in the most serious abruptions, the baby may only have a few minutes.
That is why this condition demands immediate recognition and response. There is no room for hesitation or debate. Everyone loves to have time to reflect and make decisions. Placental abruption does not afford time for The medical team must diagnose the situation, initiate emergency delivery, and restore oxygen flow before the damage becomes irreversible. These are the cases where seconds count and where a hospital’s failure to move quickly becomes the focal point of a lawsuit. The difference between a good outcome and a tragic one often comes down to how fast the team recognized the signs and acted. The standard of care does not tolerate delay when a baby is suffocating in utero.
How Dangerous is Placental Abruption?
Placental abruption is a serious complication, but its risks depend heavily on the severity of the detachment and how quickly it is recognized and treated. In the most severe cases, where a large portion of the placenta separates from the uterus, the risks can be significant. Research shows that these cases carry roughly a 15 percent risk of fetal death and as much as a 50 percent chance of resulting in neurological injury, including brain damage. However, outcomes improve dramatically when the condition is identified early and managed appropriately. With timely intervention, often through emergency delivery, many babies are delivered safely and without long-term complications. The key is rapid diagnosis and decisive action. While placental abruption is among the more dangerous obstetric emergencies, it is not an automatic tragedy if the medical team responds quickly and effectively.
How Should Doctors Respond to Placental Abruption?
When placental abruption hits in its severe form, the delivery room becomes a pressure cooker. There is no gray area in the standard of care. If the placenta separates and the fetus is in danger, the baby must be delivered immediately by emergency C-section. Not later. Not once more signs develop. Right then. Every minute that passes without intervention increases the risk of hypoxia, brain injury, or death. This is one of those moments in medicine where you either act fast or you fail completely.
The truth is that the best way to win this fight is not to wait until the emergency. It is to see it coming. The strongest defense against the chaos of placental abruption is not a scalpel or an operating room. It is smart, sustained, focused monitoring. This is where the delivery team proves whether they are paying attention or just going through the motions. Sudden maternal pain, bleeding, and changes in fetal heart rate patterns are not vague signals. They are warnings that the baby is in trouble. And once those warnings appear, the diagnosis needs to happen instantly so that delivery can begin before it is too late.
For plaintiff lawyers handling placenta abruption lawsuits, we are really focused on timing. Did the providers recognize what was happening? Did they act with urgency? Or did they lose precious time second-guessing the severity of the situation? Because with placental abruption, there is no such thing as overreacting. There is only fast or slow. And slow is where liability lives.
Getting a Lawyer for Your Malpractice Claim
If your child has suffered a birth injury and you suspect a placental abruption was mismanaged or misdiagnosed before or during delivery, call our birth injury lawyers and let’s talk about your options. We have the experience and resources to help you both get the compensation you deserve. Call Miller & Zois today and speak to a birth injury medical malpractice attorney at 800-553-8082 or get an online case evaluation.
More Malpractice Claim Information
- You see Pitocin in a common thread in many of these placental abruption malpractice cases. Too often, doctors and nurses are continuing Pitocin beyond the time it is warranted, or hospital protocols allow. These are sample settlements and verdicts in Pitocin-related birth injury cases that often involve a placental abruption.
- Cephalopelvic disproportion misdiagnosis
- Uterine rupture malpractice claims that include settlements and verdicts in Maryland involving the use of Pitocin
- Oxygen deprivation lawsuits resulting from doctors’ and nurses’ mistakes during childbirth
- Caput succedaneum malpractice cases