Placenta previa is the abnormal implantation of the placenta in the lower uterine segment. It occurs in .5% to 1% of pregnancies in the United States. So the placenta is wholly or partially covering the opening of the mother's cervix where the uterus connects the vagina. What happens is as the cervix dilates, the underlying muscular tissue disappears. The result is that the attachment of the placenta to the wall of the uterus is lost. The placenta provides nutrition, oxygen and a waste disposal system the fetus needs.
Placenta previa is, like placental abruption, a hemorrhagic disorder. Approximately 25% of pregnancy-related deaths are the result of a hemorrhage. Preterm delivery can result from these conditions which can lead to oxygen deprivation birth injuries like hypoxic ischemic encephalopathy or cerebral palsy.
So while placenta previa is often not an impediment to a healthy pregnancy, proper management of the condition is critical to a good outcome.
- What is the settlement value of placenta previa cases?
- Example placenta previa lawsuit filed in Maryland in 2017
There are three variations of placenta previa: complete, partial and marginal. With complete placenta previa, the lower intravaginal portion of the cervix (or cervical oz) is completely covered by the placenta. This is the most dangerous variation for both mother and child Marginal placenta previa is where the placenta is embedded very near to the cervical os. Partial placenta rests in the middle of those extremes.
Proper staging of this condition can be a challenge. The extent of the occlusion of the cervical oz may vary with the magnitude of the cervical dilation. So what may appear to be partial or marginal on an ultrasound before labor begins may be more serious than anticipated. Prudent doctors keep this in mind when making treatment decisions.Signs, Symptoms and Risk Factors
The biggest sign of placenta previa is painless bleeding. Some women do, however, experience contractions or cramps that may seem associated with bleeding. This bleed can be at 15 weeks but most classically present in the latter part of the second trimester or the third trimester of pregnancy.
The biggest indication of placental abruption, another hemorrhagic disorder, is painful bleeding. The pain typically feels stronger than you would expect with contractions
Other risk factors include a history of multiple pregnancies, prior history of placenta previa or a previous c-section, advanced maternal age, and cocaine or smoking.Managing Placenta Previa
Ironically, the earlier the placenta previa is diagnosed, the less of a concern that may be. If a placenta previa is diagnosed at 15 weeks, more that 80 percent of the time the placenta will move out of the way or migrate by the third trimester. Conversely, if a placenta previa is diagnosed in the third trimester, it is probably there to stay.
Most placenta previas are managed by general OB/GYNs and not sent to maternal-fetal subspecialists. There is nothing wrong with this. But the obstetrician needs to know how to properly manage this condition. Otherwise, the consequences can be disastrous.Vaginal Birth Can Medical Malpractice
A vaginal birth in the face of placenta previa is generally understood to be a breach of the standard of care if the pregnancy has reached 37 weeks or more at the time of initial bleeding. If there is a complete placenta previa, that also necessitates a c-section.
Among other things, an attempted vaginal birth when a placenta previa is present can cause or exacerbate the separation which can lead to a stroke and other injuries. The correct medical path is delivery by c-section before term because the placenta may impede the baby coming through the birth canal, and also, with contractions, there will likely be significant bleeding as the placenta is separated from the lower uterine segment, which can be fatal or significantly injurious to mother and baby.Placenta Previa Medical Malpractice and Birth Injury Claims
We see four types of placenta previa malpractice claims:
- The failure to diagnose the condition. Normally, this is the mother going to her OB/GYN complaining of painless bleed, and the doctor does not follow up with the necessary follow-up testing, most notably an ultrasound, to better diagnose the condition.
- The failure to properly treat the condition after diagnosis
- Performing a digital exam of the patient which is contraindicated
- Failure to perform a c-section
If you have been harmed or your child has suffered a birth injury because a doctor improperly managed placenta previa, the Law Firm of Miller & Zois has the experience and resources to help you both get the cash compensation you deserve for the harm you both have endured. We are based in Maryland but handle birth injury cases throughout the country. Call Miller & Zois today and speak to a newborn injury medical malpractice attorney at 800-553-8082 or get an online case evaluation.More Malpractice Claim Information