For an expecting mother, a uterine rupture often tops the list of nightmare scenarios that can cause harm to both mother and child prior to birth. A uterine rupture often results in severe injuries to the child by cutting off oxygen at a critical juncture in the child's life, while causing potentially life-threatening bleeding for the mother. This article will discuss:
- What Factors Lead to Uterine Rupture
- Long-term Effects of Uterine Rupture on a Child
- Sample Settlements and Jury Verdicts
- Steps to Take to Handle the Costs of Birth Injury from Uterine Rupture
Uterine rupture occurs when there is a breach in the wall of the mother's womb. The breach can occur in a uterus with no prior scarring but is much more common in women who have a preexisting uterine scar. Once a uterine rupture is discovered, doctors often need to perform an emergency cesarean section in order to remove the baby, as the lack of oxygen can cause serious injury. Usually, the time between recognizing that a rupture has occurred until the surgery takes place is usually 10-37 minutes. One thing is for sure. The faster the baby is delivered, the better the outcomes.
In a 25-year study on uterine rupture, risk factors found that 52 percent of the women who suffered uterine ruptures had scars from previous cesarean sections. Other risk factors include various medications the mother is placed on during pregnancy, as well as the number of children the mother has previously carried.Cervical Ripening Drugs
Another major cause of uterine ruptures (and placental abruptions) is the inappropriate use of cervical ripening drugs like Pitocin and Cervidil. The scientific literature unambiguously concludes that mismanagement of Pitocin can be a cause of uterine ruptures and placental abruptions. One study indicates that 12.5% of uterine ruptures were associated with injudicious use of Pitocin.
Birth injury defense lawyers sometimes try to deny this. But it is silly. You need to look no further than the FDA package insert for Pitocin which states that maternal deaths from "hypertensive episodes, subarachnoid hemorrhage, rupture of the uterus, and fetal deaths and permanent CNS or brain damage of the infant due to various causes have been reported to be associated with the use of parenteral oxytocic drugs for induction of labor or for augmentation in the first and second stages of labor.”
It is not only the mother who is at risk. The package insert also tells us that misuse of the drug can cause can lead to tumultuous labor, uterine rupture ... uteroplacental hypoperfusion, variable deceleration of fetal heart, fetal hypoxia... all signs the child is in trouble and is not getting the oxygen it needs.
It is also worth noting that the risks of the more pregnancies and children the mother has, the greater the risk of uterine rupture from excessive or improper use of Pitocin.Long-term Effects of Uterine Rupture on a Child
The potential complications and costs of birth injuries caused by uterine rupture are staggering. Stopping the flow of oxygen to a baby still in the womb can result in cerebral palsy or hypoxic-ischemic encephalopathy, known as HIE.
Depending on its severity, HIE can cause seizures, brain deterioration, cardiorespiratory issues, and death. Cerebral palsy can severely damage a child's basic motor skills, muscle development, and coordination.
- Maryland: $1,750,000 Settlement. A pregnant mother entered the hospital in order to have labor induced. The mother exhibited a variety of risk factors present in ruptured uterus situations, including obesity, gestational diabetes, and preeclampsia. The child was delivered 32 minutes after the uterine rupture, 42 minutes after telemetry strips first showed the possibility of a uterine rupture. As a result, the child, unfortunately, suffered from a large number of complications, including cerebral palsy, HIE, and significant hearing and vision issues.
- Maryland: $750,000 Settlement. An expectant mother walked into the hospital in order to deliver her child. After fourteen hours had passed from the time she entered the hospital, the mother was given an epidural as well as Pitocin. More than two hours after the Pitocin was administered, and after the mother complained of severe abdominal pains, an emergency C-section was performed following uterine rupture, but the child was not breathing. Attempts to revive the baby were tragically unsuccessful.
- Maryland: $400,000 Settlement. A pregnant mother who had previously undergone a Cesarean section went to the hospital to deliver her child. The defendant, an OB/GYN, placed the mother on Pitocin, a drug that induces labor, and then left to take a nap. While the defendant was napping, the mother's uterus ruptured. An emergency cesarean section was performed, but unfortunately, it was too late – the child suffered severe brain damage, and died four days after birth.
Summarized below are a handful of recent verdicts and reported settlements from national birth injury cases involving mismanagement of uterine rupture:
- Plaintiff v OB/GYN (Massachusetts 2018) $5 million: A mother was admitted to hospital for labor. She previously had a C-section with a transverse incision but was attempting VBAC. She was given Pitocin to induce labor. Fetal monitoring indicators were worrisome and accompanied by the mother experiencing pain near the site of the prior uterine incision. Defendant doctor disregarded the EFM indicators and abdominal pain and continued to administer Pitocin. Soon after a major uterine rupture occurred along the scar from the prior C-section. The baby suffered oxygen loss and was diagnosed with hypoxic-ischemic encephalopathy (HIE). Tthe he mother had an emergency hysterectomy. The case ultimately settled for $5 million.
- CV v Atlanticare (New Jersey 2017) $6.8 million: This case involved a birth injury lawsuit against the doctor and hospital for negligently failing to recognize the signs of uterine rupture and instructing the mother to continue pushing instead of immediately performing an emergency C-section. This is a pretty classic fact pattern in these types of cases. The uterine rupture caused fetal hypoxia and left the baby with HIE brain injury and severe cerebral palsy and unable to walk or function normally. The case went to mediation and parties agreed to $6.8 million settlement.
- EE v Sunrise Mountain Hospital (Nevada 2017) $12.5 million: woman was admitted to defendant hospital for labor and delivery. Labor did not progress normally and prolonged pushing allegedly caused sudden uterine rupture. Emergency C-section was completed 21 minutes after the rupture. Baby suffered oxygen deprivation causing damage to the brain resulting in severe cerebral palsy. Malpractice suit alleged that defendant was negligent in being unprepared for emergency C-section, failing to successfully intubate baby, and failing to provide postpartum brain cooling or other treatment. Defendant claimed that it acted appropriately in response to sudden and unforeseeable emergency. Jury in Clark County sided with plaintiff and awarded $12.5 million.
- Dean v Abington Memorial Hosp. (Pennsylvania 2014) $1.9 million: Baby in this case suffered HIE and died as a result of uterine rupture during delivery. Parents brought wrongful death action against doctors and hospital alleging that they were negligent in dismissing mother's complaints of severe pain on her left side, failing to properly monitor mother and baby and failing to properly read and interpret fetal monitoring indicators. The parties ultimately settled the case for just under $2 million.
A ruptured uterus causes many long-lasting complications for both the mother and child, complications that can lead to astronomical costs for care. When a ruptured uterus occurs during the birthing process, it is extremely important for the mother to consider the possibility of pursuing legal action, especially if various risk factors for uterine rupture were present but not adequately addressed by the doctors. Call 800-553-8082 or visit us online to get a free case evaluation.