Placental Insufficiency Malpractice

The placenta is a critically important organ during pregnancy. Together with the umbilical cord, it acts as the lifeline between mother and baby. The placenta allows for the delivery of maternal oxygen and nutrients to the baby during gestation. It also plays a central role in hormone production and immune protection. Without a healthy, functioning placenta, fetal development is placed at serious risk.

Oxygen is really the key. So many birth injury medical malpractice lawsuits that our lawyers see involve a compromised placenta that is not meeting the child’s oxygenation needs. In cases where the problem is easily anticipated or there are signs that the fetus is in distress, it is incumbent upon the doctors to take appropriate action. Often, that action means delivering the child via emergency C-section, or, at the very least, holding the mother for extended monitoring to protect against a worsening of the problem or to respond quickly to an acute hypoxic event.

What is Placental Insufficiency?

Placental insufficiency (also called placental dysfunction or uteroplacental insufficiency) is an infrequent but potentially very dangerous pregnancy complication. It occurs when the placenta develops abnormally or becomes damaged at some point during the pregnancy. These abnormalities result in a significant reduction of maternal blood flow to the baby. As a consequence, the placenta fails to deliver enough oxygen and nutrients to the fetus, both of which are essential for normal development.

Placental insufficiency essentially means that the placenta is not doing its job. The fetus isn’t receiving the oxygen and nutrients it needs to grow, thrive, and develop. This leads to a cascade of problems, most notably intrauterine growth restriction (IUGR), low birth weight, and premature birth. Each of these significantly increases the risk of injury. Without timely diagnosis and intervention, placental insufficiency can cause permanent brain damage, stillbirth, or neonatal death.

The risk posed by placental insufficiency can evolve quickly. In high-risk pregnancies, especially those involving twins, and particularly monochorionic diamniotic twins sharing the same placenta, the danger compounds. We are currently handling such a case involving twin-twin transfusion syndrome, a rare and life-threatening complication often tied to placental function. The margin for error in these cases is razor-thin, which is why the standard of care demands heightened monitoring and readiness to act.

When signs or symptoms of placental insufficiency appear, doctors and nurses must respond. Delay in recognizing these signs, or choosing not to act on them, can lead to preventable tragedy. When that failure results in harm to the child, it is grounds for a medical malpractice claim.

Understanding the Placenta’s Role in Pregnancy

The placenta is not a static structure. It is a dynamic, complex organ that develops specifically for each pregnancy. A new placenta grows inside the uterus where the fertilized egg implants in the uterine wall. The umbilical cord develops from the placenta and forms the physical link between the mother and fetus.

The maternal and fetal blood supplies do not mix. Instead, the placenta filters oxygen and nutrients from the mother’s bloodstream and transfers them into the fetal circulation. It also removes carbon dioxide and waste products from the fetal bloodstream for disposal by the mother. The placenta functions as the fetus’s lungs, kidneys, and digestive system until birth.

Importantly, the placenta continues to grow throughout gestation. As the fetus grows larger, the need for oxygen and nutrients increases, and so the placenta must expand and increase its functional capacity. A healthy, full-term placenta typically weighs about 2 pounds. After the baby is delivered, the placenta is usually expelled naturally from the mother’s body.

When placental development is impaired or the organ becomes damaged, its function declines,, and the baby suffers the consequences. Placental insufficiency represents a failure of the placenta to adapt and meet the demands of the growing fetus.

What Causes Placental Insufficiency?

Placental insufficiency is usually rooted in impaired maternal circulation. Anything that interferes with the flow of nutrient and oxygen-rich blood to the placenta can compromise its function. Common maternal health conditions that increase the risk of placental insufficiency include:

• Diabetes
• Anemia
• Hypertension (high blood pressure)
• Blood clotting disorders
• Cardiovascular disease
• Autoimmune disorders

In addition, certain medications and lifestyle choices ( smoking and drug use are obvious, the use of prescription blood thinners, less so) can affect placental health.

Placental insufficiency may also be secondary to other placental complications, including:

• Placental Abruption: a serious complication in which the placenta suddenly detaches from the uterine wall during pregnancy.
• Placenta Previa: where the placenta is located in the wrong place inside the uterus and is fully or partially blocking the entrance to the birth canal.
• Placenta Acreta: a complication occurring where the placenta attaches too deeply into the uterine wall.

While many of these risk factors are beyond the control of the pregnant person, proper prenatal care includes identifying and managing these risks early. When doctors fail to do so and an injury results, the basis for legal liability becomes pretty obvious.

The Stakes in Placental Insufficiency Malpractice Cases

Placental insufficiency is not just a medical complication. It is often the first clear signal that a pregnancy is in jeopardy and that medical professionals must act decisively. That is where the rubber meets the road in these types of lawsuits.  These cases expose how frequently the systems meant to protect mothers and babies fail to do so. Prenatal care, fetal monitoring, and hospital triage protocols are supposed to catch and respond to these warning signs. In too many cases, they do not.

The danger of placental insufficiency develops over time, but the medical response often does not keep pace. The fetus stops growing at a normal rate. Fundal height measurements shrink. Fetal heart tracings show signs of distress. These are not subtle indicators. They are bright red flags. That monitor is how the baby talks to us.  When doctors and nurses ignore or misinterpret them, there is often no second chance. The results are often catastrophic and irreversible.

This is where the legal significance becomes unavoidable. When a physician fails to recognize that a baby is at risk due to impaired placental function, that is a deviation from the accepted standard of care. When a hospital delays delivery despite evidence of fetal compromise, that is negligence. And when that negligence causes permanent injury or death, families have every right to demand accountability.

Placental insufficiency malpractice cases are not only about oxygen levels and ultrasound readings. They are about whether the medical professionals entrusted with protecting vulnerable pregnancies act with the urgency and precision the situation demands. When they fail to do so it is not just a breakdown in care. It is a breach of responsibility. That is why these cases matter and why we pursue them.

How Placental Insufficiency Harms the Baby

The most immediate and dangerous consequence of placental insufficiency is oxygen deprivation. Without sufficient oxygen and nutrients, fetal organs (especially the brain) are highly vulnerable. The risk of a hypoxic-ischemic injury increases dramatically in the setting of placental dysfunction.

Specific risks and complications include:

• Intrauterine growth restriction (IUGR): When the fetus fails to grow at a normal rate. This is often one of the first signs that something is wrong.
• Premature birth: Babies delivered early due to placental concerns are more vulnerable to infection, organ immaturity, and developmental delays.
• Stillbirth: A severe form of placental insufficiency can result in fetal demise.
• Neonatal hypoglycemia and polycythemia: These can develop when nutrient delivery is compromised and fetal red blood cell production ramps up in an attempt to compensate for low oxygen.

Long-term, the most devastating injuries stem from hypoxic events. These include:

• Cerebral palsy: A motor disorder caused by brain injury before, during, or shortly after birth.
• Cognitive delays and learning disabilities: Chronic under-oxygenation can result in significant neurodevelopmental impairment.

Again, many of these injuries are preventable with timely delivery and appropriate prenatal care.

How Placental Insufficiency Is Diagnosed

There is no surgical fix for a poorly functioning placenta. Once the placenta starts to fail, the only viable path forward is to closely monitor both mother and baby and deliver when necessary. That makes early detection absolutely critical.

Diagnosis is generally made through a combination of clinical suspicion and confirmatory testing. Tools for diagnosis include:

• Prenatal ultrasound: This helps assess fetal growth, amniotic fluid levels, and placental size or position.
• Doppler flow studies: Measures blood flow in the umbilical artery, giving insight into placental function.
• Non-stress and biophysical profile testing: These monitor fetal heart rate and general well-being.
• Maternal blood work: Alpha-fetoprotein levels, for example, can sometimes signal problems.

A hallmark of malpractice cases involving placental insufficiency is the failure to order or act upon these basic tests. When OB/GYNs ignore warning signs, like reduced fetal movement, a small fundal height, or abnormal test results, the standard of care has been breached.

Managing Placental Insufficiency

Once placental insufficiency is identified, good doctors can find a path to best manage the problem. Management revolves around two main strategies: treating the underlying maternal conditions and timing the delivery to minimize fetal harm.

Treatment may include:

• Medications to manage blood pressure or diabetes
• Nutritional counseling and supplementation
• Corticosteroid injections to accelerate fetal lung development in case of preterm delivery
• More frequent ultrasounds or fetal monitoring

Often, the safest option is to deliver early. The longer a fetus remains in an environment of poor placental function, the higher the risk of permanent injury. So whether there is a viable medical malpractice often hinges on timing… did the OB wait too long to act?

Placental Insufficiency and Medical Malpractice

Doctors and hospitals have a legal duty to recognize the signs of placental insufficiency and respond appropriately.

In our experience, malpractice involving placental insufficiency falls into two main buckets:

1. Failure to diagnose: Ignoring fetal growth restriction, abnormal testing, or maternal risk factors.
2. Negligent management post-diagnosis: Recognizing the problem but delaying intervention or failing to escalate to a higher level of care.

The key legal question in every case is whether a competent OB/GYN acting reasonably under the circumstances would have made a different decision and whether that decision would have prevented the injury.

Examples of Placental Insufficiency Verdicts and Settlements

There are not a large number of publicly available verdicts and settlements involving placental insufficiency. Many of these cases, particularly those involving severe birth injuries like cerebral palsy or stillbirth, are resolved through confidential settlements before they ever reach trial.

Hospitals and malpractice insurers are often eager to avoid public scrutiny in these emotionally charged cases, especially when there is clear evidence of delayed diagnosis, failure to monitor, or negligent management of high-risk pregnancies. As a result, the handful of verdicts that do make it to a courtroom represent only a small fraction of the true volume of litigation tied to placental dysfunction. Still, these reported outcomes provide insight into how lawyers, hospitals, insurance companies, and juries assess liability and damages in cases involving compromised placental function.

• Confidential v. Confidential (Illinois, 2023) – $29 million settlement: Mother presented at 28 weeks with symptoms later diagnosed as placental abruption. Plaintiffs claimed that the hospital failed to recognize signs of fetal compromise and delayed emergency delivery. The baby was delivered with severe hypoxic brain injury and later diagnosed with spastic quadriplegic cerebral palsy. The case settled prior to trial for $29 million.
• Iniestra v. Silva (Illinois, 2014) – $525,000 verdict: Baby diagnosed with IUGR due to placental insufficiency was delivered stillborn. Lawsuit alleged OB/GYN failed to order a Level III ultrasound or closely monitor fetal development. The jury awarded damages for wrongful death.
• Crowell v. Kirner (Pennsylvania, 2013) – $55 million verdict: Baby born with severe cerebral palsy. Plaintiffs argued that failure to anticipate macrosomia and oxygen deprivation during delivery was exacerbated by the doctor’s incorrect assumption of placental insufficiency. The jury sided with the plaintiffs and gave what is obviously a huge award
• Stetson v. Nunez (New Jersey, 2013) – $9.6 million verdict: OB/GYN allegedly failed to measure fundal height, missing the absence of fetal growth. The resulting delay in diagnosis led to hypoxic brain injury and spastic cerebral palsy. The jury awarded significant damages.
• Hodge v. Knott (Michigan, 2011) – $287,500 settlement: Stillbirth attributed to failure to train hospital staff on how to manage IUGR and placental insufficiency. Case settled prior to trial.

These cases reveal a common thread: placental issues are often visible in hindsight but tragically overlooked in real-time.

Hire a Birth Injury Lawyer for Placental Insufficiency Cases

If your baby suffered a birth injury related to placental insufficiency, you may have a valid legal claim. Families often don’t realize what went wrong until years later. A qualified birth injury lawyer can help you uncover the truth and pursue justice.

At Miller & Zois, we’ve handled numerous cases involving placental insufficiency, delayed C-sections, and preventable birth injuries. We understand the medical nuances and the legal standards and we fight to hold negligent doctors accountable.

Call us at 800-553-8082 or contact us online.