A placental abruption is a serious complication that can arise late in pregnancy. There is no treatment for a placental abruption. It can cause serious injury to the baby or even result in a stillbirth. In certain cases it can also lead to the death of the mother. When a pregnant patient presents with symptoms that indicate the possibility of a placental abruption, doctors and nurses must either rule out the possibility of a placental abruption or take action immediately in order to protect the baby and the mother.
A placental abruption is often accompanied by heavy vaginal bleeding and by pain in the lower back and abdomen. Depending on where and how much of the placenta separates from the uterus, however, there may be no visible bleeding. Other symptoms that may indicate a placental abruption include a drop in the fetal heart rate as the unborn baby is deprived of oxygen, a change in blood pressure, and unusual contraction patterns.
The following cases illustrate how doctors and nurses sometimes miss these symptoms
Case 1:
This case involved a pregnant woman who at age 38 went to see her obstetrician with persistent vaginal bleeding accompanied by back and abdominal pain. She was sent home. The next day she went to the hospital due to massive vaginal bleeding. The doctor at the hospital interpreted the readings from the fetal heart rate monitor as reassuring. The doctor concluded that labor had not yet commenced. Without conducting a full workup for the bleeding and the fail and without ordering an ultrasound the doctor and sent her home even though she continued to complain of vaginal bleeding accompanied by abdominal pain. Her symptoms had been caused by a placental abruption. The baby was later born still. The law firm that handled this matter reported that the case went to trial with a resulting verdict of $1,651,166.
Case 2:
This case involved a series of errors by hospital staff that resulted in the stillbirth of a baby due to a placental abruption. First, upon admission she was noted to have high blood pressure during her initial examination. For the rest of the time the woman was in labor no other blood pressure readings were taken. Second, the woman experienced unusual contraction patterns but the labor and delivery nurse did not consider a placental abruption as the cause. Finally, he nurse did not make any effort to increase the IV fluid rate or to administer oxygen as resuscitative measures. A settlement in the amount of $300,000 was reported by the law firm that handled this matter.
Analysis:
In the first case above, the woman had the two main symptoms of placental abruption. By the time she reported to the hospital she experienced what was described as "massive" bleeding. The doctor, however, focused only on the fetal heart rate readings ignoring the danger that existed not only for the baby but for the mother who could go into shock or even die from the loss of blood.
In the second case, there was no visible bleeding. There was, however, a high blood pressure reading and unusual contraction patterns. It is not clear from the report of the case whether there were also any signs of fetal distress. The doctor left a labor and delivery nurse to monitor the labor and the nurse made no effort to notify the doctor of these troubling signs or to administer resuscitative measures in an attempt to save the baby.
When doctors and nurses do not take appropriate action in the presence of symptoms that suggest the presence of a placental abruption and there is resulting harm to the baby and/or the mother, they may be subject to a medical malpractice claim.
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