Did Your Doctor Miss Sign…

If you gave birth in a hospital, chances are that you when you were admitted to Labor and Delivery, you were attached to a variety of monitors. Those monitors allowed doctors and nurses to keep an eye on the progress of your labor, as well as your vital signs and those of your baby. It is important to monitor things like the baby’s heart rate and oxygen level, because changes can indicate fetal distress (also called “non-reassuring fetal status”).

Fetal distress signals more than just temporary discomfort for your baby. Fetal distress means that the baby isn’t getting adequate oxygen, or is otherwise unwell. Distress usually registers as a change in heart rate on the monitors. Of course, insufficient oxygen for an extended period can cause all kinds of problems, including permanent brain damage and death.

Normally, when medical staff become aware of fetal distress, they spring into action and take steps to alleviate the distress or hasten the birth, often by emergency C-section. If a doctor misses signs of fetal distress that should have been detected, it may constitute medical malpractice.

What Causes Fetal Distress?

Fetal distress may be caused by a number of conditions or factors. These include:

  • Anemia
  • Low amniotic fluid levels (oligohydraminos)
  • Intrauterine growth retardation (IUGR)
  • Preeclampsia or eclampsia
  • Umbilical cord prolapse (the umbilical cord drops into the birth canal ahead of the baby, and becomes compressed)
  • Prolonged labor
  • Placental abruption (the placenta separates from the wall of the uterus)
  • Shoulder dystocia (the baby’s shoulder gets caught above the mother’s pubic bone, delaying delivery) or other abnormal positioning of the baby
  • Meconium in the amniotic fluid (the baby’s first stool, or meconium, if present in the amniotic fluid, can block the baby’s airways)
  • Post-term pregnancy (42 weeks or longer)

The common thread in all of these is that they may cause insufficient oxygen to reach the baby during pregnancy or labor.

How is Fetal Distress Detected and Treated?

As mentioned above, monitoring fetal heart rate can indicate fetal distress. Electronic fetal heart rate monitoring allows medical staff to recognize that hypoxia (insufficient oxygen) is developing by analyzing fetal heart rate patterns. Fetal heart rate monitoring also allows care providers to note how the baby is responding to hypoxia, as well as to monitor the mother’s contractions during labor.

Fetal heart rate monitoring is not entirely without risk. If results of monitoring are misinterpreted, a mother could be subjected to an unnecessary C-section. However, most professionals would agree that this risk does not outweigh the risk of damage from unaddressed fetal distress.

Although a C-section to get the baby out quickly is sometimes required as a response to fetal distress, there are other treatments, collectively known as “intrauterine resuscitation,” which may be tried before resorting to a C-section. These include:

  • Changing the laboring mother’s position to speed labor along
  • Making sure the laboring mother has enough oxygen and hydration
  • Infusing fluid into the amniotic cavity to relieve compression of the umbilical cord (amnioinfusion)
  • Giving medication to stop contractions, if the mother is going into preterm labor
  • Giving the mother IV hypertonic dextrose to combat low blood sugar.

How Does a Doctor Miss Fetal Distress?

With all of the technology available to monitor a baby’s heart rate, oxygen level, and other vital signs, you would think it would be very difficult for trained medical professionals to miss signs of fetal distress. Unfortunately, signs that should have been caught are often missed.

If a doctor is aware that a mother has a condition, like pregnancy-induced hypertension, that can lead to fetal distress, he or she should be especially diligent about monitoring fetal health during pregnancy and especially during labor. Failure to conduct proper monitoring when there are risk factors present may constitute obstetrical medical malpractice. If a doctor does order monitoring, but fails to review or to correctly interpret the results, that, too, may constitute malpractice.

Brain damage or infant death due to untreated fetal distress is especially heartbreaking because it is often preventable. Instead of parents returning home with the healthy baby they expected, they may return home with one who needs a lifetime of expensive care, or worse, may return home with empty arms.

If your baby suffered a birth injury such as hypoxic ischemic encephalopathy, you may need financial help to care for them, but you have only a limited period of time in which to make a claim against your medical provider for malpractice. We encourage you to contact our law office to schedule a consultation to discuss your situation and your options.