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You are here: Home / Malpractice A-Z / Prenatal Care

Prenatal Care

See Also:

  • Birth Injury
  • Cerebral Palsy
  • Erb’s Palsy
  • Stillbirth

No time is more fraught with joy mixed with anxiety than pregnancy. Every mother wants to do everything possible to have a healthy baby. No one even wants to think about the possibility that the doctor they trust as their guide through this prenatal time may fall down on the job. Yet it happens sometimes, and the consequences can devastate both mother and child. When these consequences happen – an injury to the mother or baby, even a death – a medical malpractice lawsuit is a possibility that few want to think about but that responsible families sometimes must consider.

Here are some of the common problems with prenatal care that can lead to harm and that sometimes can justify a consultation with a medical malpractice lawyer:

  • Failure to diagnose and treat high blood pressure in the mother (maternal hypertension);
  • Failure to diagnose and treat diabetes that starts in pregnancy (gestational diabetes);
  • Failure to conduct regular fetal ultrasounds in order to keep track of the baby’s size and weight;
  • Failure to recognize the symptoms of a serious condition late in the pregnancy such as pre-eclampsia (pregnancy-induced hypertension); placental abruption or premature rupture of the membranes.
  • Failure to do tests late in the pregnancy, especially when there is any indication of a high-risk pregnancy, to make sure the baby is healthy and can withstand the stress of a normal vaginal birth.

Here is more information about these issues:

Premature Rupture of Membranes

Premature rupture of membranes happens when the “water breaks” at any time before the 37th week of pregnancy. This occurs in roughly three percent of pregnancies but is the cause of approximately one-third of all preterm deliveries.

Prompt treatment of premature rupture of membranes is essential in order to prevent serious, life-threatening consequences, such as:

  • Infection in the baby.
  • Placental abruption
  • Umbilical cord prolapse (a loop of the umbilical cord falls out of the vagina)
  • Interruption of blood flow to the baby, causing brain damage.

When the membranes rupture before the 37th week of pregnancy, the mother needs to be hospitalized immediately and put on monitoring equipment. Steroid drugs are often given before delivery to help mature the baby’s lungs. Sometimes the baby has to be delivered early by Cesarean section.

High blood pressure in Pregnancy – Pregnancy-Induced Hypertension

Pre-eclampsia High blood pressure (hypertension) occurs in almost one in ten pregnancies. Pregnancy may induce hypertension or aggravate a woman’s pre-existing blood pressure. When high blood pressure happens in pregnancy, the risk increases that some injury could occur to mother or baby. The baby’s growth can slow, it can develop oxygen insufficiency, birth may be premature, and the mother can even suffer seizures if the high blood pressure worsens.

An obstetrician may respond to these potential complications by checking the mother’s blood pressure more often, hospitalizing the mother for testing and observation, giving drugs to lower the pressure, ordering lab tests or even deciding that the baby needs to be delivered early.

Hypertensive conditions of pregnancy are classified by when the high blood pressure is found and what else is going on at the same time.

  • When the patient develops high blood pressure before becoming pregnant, or is diagnosed before the 20th week, the condition is called chronic hypertension. This may be mild or severe, depending on the blood pressure measurement. Patients who have chronic hypertension are at increased risk for developing more serious complications at a later stage of the pregnancy.
  • If the patient develops hypertension after the 20th week, this is called pregnancy-induced hypertension. If hypertension is accompanied by protein being spilled in the urine (proteinuria) or swelling of feet, hands or the face, caused by retaining fluid, then the term is pre-eclampsia. Proteinuria is usually detected by a dipstick reading at the prenatal visit.

Swelling (edema) is the least important indicator because it is a normal finding in many pregnancies. However, edema of the hands and face is significant when hypertension is present and accompanied by excessive weight gain.

The signs of elevated blood pressure, proteinuria, and edema are important not only in diagnosing preeclampsia, but also in determining how bad it is. Therefore, the patient’s blood pressure, urine, and weight gain should be checked at each prenatal visit.

Other things that show this situation is getting worse include: visual disturbances, ranging from slight blurring to partial or complete blindness; severe headaches; and right upper abdominal pain.

Preeclampsia is life-threatening when several factors combine to produce a condition known as the HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count). Another life-threatening complication, called eclampsia, arises when preeclampsia is accompanied by convulsions. Either of these may require the prompt delivery of the baby, regardless of the stage of pregnancy, to protect the mother.

There is no cure for preeclampsia other than ending the pregnancy. But this can hurt the baby if it’s too soon. This is one reason why it’s important for the doctor to accurately determine the age of the fetus.

Prenatal testing late in pregnancy

Before a mother goes into labor, tests are available to determine if an at-risk baby can undergo the stresses of a labor and vaginal delivery and come out healthy. The situations that call for testing include:

  • Decreased movement in the womb;
  • High blood pressure in the mother (pregnancy-induced hypertension or pre-eclampsia);
  • Diabetes;
  • Reduced amniotic fluid, meaning the baby is not urinating normally in the uterus (called oligohydramnios);
  • Baby is too small for its age in the womb (called intrauterine growth retardation);
  • Baby is overdue.

These pre-labor tests of the baby all involve looking at the baby with ultrasound or watching the baby’s heartbeat (compared to the mother’s uterine contractions if there are any) to see if the baby’s heart rate speeds or slows at the wrong time.

Consult with an Experienced Malpractice Attorney

If you believe you or a family member has been seriously injured from medical malpractice, medical error, or neglect by a doctor, hospital, nurse, clinic, nursing home or other health care provider, you may want to click here to contact an experienced medical malpractice attorney for a free evaluation of your case. You can also email us at info@patrickmalonelaw.com or call us at 202-742-1500 or 888-625-6635 toll-free. We will respond within 24 hours. There is no charge for our initial consultation.

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