New Jersey Postpartum Hemorrhage Lawyers
Maternal bleeding after childbirth, while common, can be extremely dangerous. In fact, roughly 3 to 5% of birthing women experience excessive bleeding after delivery, and postpartum hemorrhage accounts for an estimated 12% of maternal deaths in the United States. According to the American College of Obstetricians and Gynecologists (ACOG), a total blood loss of 1,000 milliliter (mL) within one day of giving birth constitutes postpartum hemorrhage. Notably, maternal bleeding can also occur before birth of the placenta and up to one day after delivery of the baby. The physical and psychological consequences of maternal hemorrhage exist on a spectrum of severity, ranging from postpartum depression to death. Given the emergency nature of postpartum bleeding, doctors must not only be prepared and vigilant, ready to curb and prevent further blood loss, but they must also select and implement the right treatment for the right patient.
Obstetricians, treating physicians, and specialists in pregnancy and birth-related matters should ensure that they are prepared for emergency treatment when a woman bleeds excessively before or after delivering her child, or risk both lives involved. When it comes to labor and delivery, unprepared, neglectful, or otherwise negligent doctors can potentially cause significant harm to the women and children under their care. Those who cause childbirth injuries or wrongful death by failing to recognize the signs of maternal hemorrhage, not identifying the cause of bleeding, negligently determining the amount of blood loss and appropriate treatment required, or not treating the condition with ready supplies, quick reactions, and the full range of expertise that comes from practicing and education, may be liable for medical malpractice.
If you would like to speak with an attorney regarding malpractice with maternal bleeding and postpartum hemorrhage in New Jersey, contact Fronzuto Law Group today. Our dedicated team offers free consultations and we are happy to review your case free of charge.Fronzuto Law Group
Possible Causes of Maternal Bleeding
Uterine atony, a condition that results from the uterus failing to contract after delivery, is the leading cause of postpartum hemorrhage. Other sources of major bleeding include: uterine rupture, hematoma, tears, cuts, retained placental tissue, lacking blood clot formation, and uterine inversion.
What are the Risk Factors for Postpartum Hemorrhage?
What makes this condition so difficult to detect and therefore, avoid complications, is the lack of warning signs that it may occur during the pregnancy stages. One-fourth of the women with this condition have no risk factors for it, so physicians must be prepared to deal with maternal bleeding amidst any birth and in the time that follows. If women do have a high risk for bleeding due to various personal factors, they may need to deliver at facilities that permit immediate access to surgery, intensive care, and blood storage services. Women at risk for hemorrhaging often have bleeding during the delivery phase before the birth of the baby, prolonged labor, amniotic infection, larger-than-average babies, anemia, obesity, multiple fetuses, preeclampsia, and augmented labor (using medication to enhance contractions). They are usually first-time mothers as well.
Can Maternal Hemorrhage after Birth be Prevented?
Healthcare professionals can reduce death rates due to hemorrhaging for these women by preparing for the event through personnel readiness, available supplies to treat bleeding, emergency transfusion protocols, and timely and accurate diagnosis. They are responsible for assessing the mother and baby’s condition before birth and then addressing underlying or resulting conditions like anemia and sickle-cell anemia. Using sonograms to detect placenta problems, identifying patients likely to decline blood transfusions, avoiding instrument delivery by forceps or vacuum extractors, carefully monitoring vital signs, and using warm compresses on the perineum, are also methods to prepare for maternal bleeding. However, the most effective way to prevent bleeding is by actively managing the birth and pushing phase of labor. This can be achieved with medications to induce contractions, uterine massage, and delivering the placenta using controlled cord traction (controlling the blood flow from the cord at delivery).
Since the problem arises relatively often and is potentially fatal, physicians delivering babies must take the appropriate care during the pushing stage of labor to prevent maternal hemorrhage; for example, by using oxytocin to address uterine atony. Another preventative measure is circumventing unnecessary episiotomy, which is what doctors do to widen the vaginal opening and avoid a serious tear by cutting the perineum. The additional blood loss in episiotomy heightens the risk of a dangerously low blood flow. Some doctors routinely perform episiotomies and therefore, cause unnecessary bleeding.
Complications from Postpartum Hemorrhage
Despite the variability among possible causes, the most important measure for avoiding postpartum hemorrhage is early diagnosis and treatment. When maternal bleeding and its source are discovered early, medical professionals can administer a blood transfusion and medications within the first few hours of birth, which can help to stem bleeding and reduce the risk of death by postpartum hemorrhage, or further injury to the mother or baby.
Complications of postpartum hemorrhage include:
- Excessive blood loss
- Pituitary gland malfunction
- Blood clot issues
- Heart problems
- Low blood pressure
- Postpartum depression
Recognizing the Signs of Postpartum Bleeding and Diagnosis
A physician first must become aware that postpartum bleeding exists, and delivery specialists must not negligently miss the signs of hemorrhage early to protect the lives of both mothers and babies. To diagnose the condition, doctors must recognize unusual bleeding and accompanying signs; find its cause, such as trauma, uterine atony, clotting, or placenta or tissue problems; and take action. After birth, blood loss is typically monitored throughout delivery and post-delivery and measured by weighing blood-soaked pads, sponges, and the like, making sure the blood loss does not exceed 1,000 mL. Also, doctors must check for rapid heart rate, low blood pressure, nausea, and chest pain as symptoms of hemorrhage. From diagnosis, doctors must treat the source quickly.
Treatment and Management of Postpartum Hemorrhage
Leaders in the medical field generally recommend a highly practiced team response, readily available dedicated supply carts, and advanced training in obstetrics and management of such serious complications as maternal hemorrhage after birth. Once found, management includes responsiveness to the situation, whether it calls for resuscitation, oxytocin, closing lacerations, removing the placenta, replacing platelets or other clotting agents, and/or blood transfusion. Treating postpartum hemorrhage may require oxygen, placement on a ventilator, intravenous fluid, blood replacement, leg elevation, bladder drainage, and added plasma to blood transfusions, if necessary. Packing the uterus with gauze, closing off arteries to stop bleeding, compression sutures, uterine compression, and balloon tamponade (balloon inserted into the cervix to stop bleeding) are all methods used to put an end to heavy bleeding. The last resort to stop bleeding is a hysterectomy. Post-treatment follow up should include blood loss monitoring, vital signs monitoring, as well as checking for anemia and possible PTSD.
Bleeding Caused by Uterine Atony
Uterine atony, the most common bleeding cause after childbirth, is handled by compressing the uterus with one hand in the vagina pushing against the body of the uterus and the other pushing down on the abdominals, along with medications. Also, lacerations and hematomas (blood pooling around a blood vessel) from birth cause excessive bleeding, but can be treated by mending the tears or cuts. Furthermore, hematomas may have to be drained and sewn up. Another cause called uterine inversion, though rare, can lead to excessive bleeding or shock when the uterus protrudes outside of the birth canal or delivers with the placenta. The obstetrician must put it back inside the woman and give her medications to improve uterine tone.
Hemorrhaging from Ruptured Uterus
The second most common cause, uterine rupture, may be suspected if the woman experiences abdominal tenderness, rapid heart rate, vaginal bleeding, halted uterine contractions, low blood pressure, and a swelling abdomen. It may occur with fetal bradycardia (fetus’s abnormal heartrate). Also, tissue from the placenta or blood clots remaining inside the uterus may prevent uterine contraction effectiveness and cause a gush of blood, or the placenta does not deliver. ACOG recommendations suggest that if more than nine minutes elapse from birth of the baby to birth of the placenta, the placenta may require manual removal. This happens when the placenta develops too deeply into the uterine wall, a condition called placenta accreta, and causes postpartum hemorrhage. Risk factors for an in-grown placenta include advanced maternal age, previous pregnancies, and previous placenta accreta or placenta previa.
Blood Clotting Problems causing Excessive Bleeding after Delivery
Blood clotting defects may also cause hemorrhage, whether arising congenitally or environmentally. Treatment of the underlying condition causing the blood clotting problem is the first line of defense against uncontrolled bleeding, followed by platelet and other coagulant agent replacement. Blood clotting disorders may result from amniotic fluid embolism, excessive bleeding, fetal death, HELLP syndrome (high liver enzymes and low platelet levels), placental abruption (tearing away from the uterine wall), preeclampsia, maternal infection, aspirin use, genetics, hemophilia, and other blood clotting diseases.
Who to Turn to when Postpartum Hemorrhage Malpractice Happens to You in NJ
If you or someone you know suffered harm from a medical professional’s mishandling of postpartum hemorrhage, be sure to contact an experienced medical malpractice and birth injury attorney for a better understanding of your legal remedies in situations like these. Whether a doctor has committed malpractice is determined by intensively reviewing the steps that the doctor took, or did not take, to handle a patient’s maternal hemorrhage. This is best accomplished by a highly qualified lawyer, coupled with a medical expert review to determine if such action or inaction was negligent as measured against the accepted medical professional standards of a doctor or specialist in similar circumstances. If negligence did, in fact, occur in your case, you can obtain compensation for the economic and emotional losses you experienced at the hands of any and all liable parties.
At Fronzuto Law Group, our legal team fights for those injured by healthcare professionals and facilities that fail to take preventive measures or fail to diagnose and treat maternal bleeding in time to save lives and turn the tide against life-altering injuries. You can read about one of our clients who died after delivering twins and experiencing massive hemorrhaging due to undiagnosed and untreated preeclampsia. Those whose wrongful actions caused you or your loved one injury need not go unpunished. Call our New Jersey offices today at 973-435-4551 to discuss your case and learn more about how we can help.
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