Some women are at greater risk for medical conditions and events that can harm their developing fetuses or endanger their own lives. Improved technology and extensive medical research have provided doctors with the tools they need to identify situations that carry a higher rate of risk for babies. We know which situations are potentially dangerous, and when extra care should be taken.
In most cases, doctors who do not have experience managing these high-risk situations should inform their patients and refer them to obstetricians who are familiar with the duties and treatments involved. If a doctor accepts a patient in these circumstances, he or she is expected to know and understand how to properly manage the pregnancy.
The following are some ways that proper medical care and treatment could help expectant mothers avoid problems during pregnancy:
- Extra prenatal visits;
- Amniocentesis;
- Additional ultrasounds;
- Further testing (urine, blood, genetic);
- Blood pressure checkups;
- Being seen by regular doctor and a maternal-fetal specialist or perinatologist;
- Closer monitoring of fetus;
- Treatment options (hospitalization, medication, bed rest, etc.); and
- Delivery in a specialized hospital.
If doctors and staff are not proactive in screening and diligent in managing a high-risk pregnancy, they should be held accountable when the mother or baby is injured or dies. The birth injury attorneys at The Becker Law Firm help families who have suffered significant harm because of negligent management of a high-risk pregnancy, labor, or delivery.
Contact us online or by phone at 216-621-3000 to request your free, no-risk consultation.
Examples of High-Risk Pregnancies
At The Becker Law Firm, we have a long record of success in cases involving mismanagement of high-risk pregnancies, including those involving:
- Advanced maternal age: Women who are 35 or older are considered to be of advanced maternal age, which carries a series of heightened risks over what younger mothers experience. Managing obstetricians should take care to diagnose genetic problems, to watch for problems in blood pressure, and to take care of the baby and the mother.
- Premature birth: Premature babies are far more susceptible to developmental problems, delivery trauma, and neonatal death. 12.5% of the babies born in the United States are premature. Prematurity can lead to extensive physical and mental problems, including cerebral palsy, developmental delays, and death. Obstetricians have an opportunity to prevent prematurity in some cases, giving the baby adequate time to grow.
- Twins, triplets, or other multiples: The rate of multiple births has increased in recent decades and, with it, the risk of complications from a mismanaged pregnancy or delivery. Whether naturally occurring or because of fertility treatments, there are unique risks involved when having multiple children at the same time. Careful doctors must take care to manage the pregnancy and to monitor for complications like placental abruption, fetal distress, gestational diabetes, and a prolapsed umbilical cord, to name a few.
- Suspected large fetus: Babies who weigh over 8 lbs., 13 oz. may be at risk for injuries, including particularly brachial plexus injuries caused by the baby becoming stuck in the birth canal. Doctors must be able to identify possible macrosomia and handle the complicated delivery. Mistakes can include the failure to accurately gauge the size of the fetus and the failure to manage the delivery.
- Vaginal Birth After Cesarean (VBAC): Women who have had a previous C-section are at an increased risk of uterine rupture if they attempt a vaginal delivery. Women may choose to have a vaginal birth after cesarean, but there are specific criteria that they must fulfill before a doctor allows them to undergo a course of labor. The risks to the baby include uterine rupture, cerebral palsy, and stillbirth.
- PROM and P-PROM: The rupture of membranes (water breaking) is a key event that defines the duty of doctors and nurses up through labor. Particularly if the water breaks while the baby is premature, there are a series of actions the doctor must take to ensure the health and safety of the baby. Care must be taken in cases involving premature rupture of membranes (PROM) and preterm premature rupture of membranes (P-PROM). This includes a timely and proper course of antibiotics.
Use of Maternal-Fetal Specialists
Doctors who manage high-risk pregnancies, called maternal-fetal specialists or perinatologists, have specialized training in handling the common and uncommon problems that accompany many pregnancies.
Perinatology is a subspecialty of obstetrics and gynecology. In addition to the same education and training as an OB-GYN, perinatologists additionally undergo three years of specialized training. They are particularly equipped to handle mothers with significant medical conditions, and fetuses who are at risk because of genetic, environmental, or other factors.
In some cases, maternal-fetal specialists are called in to deal with existing problems; other times they manage pregnancies from the beginning because an expectant mother may have an especially high risk of developing complications. They will often work with a woman’s obstetrician or may take over care when a high-risk designation is given.
When Is a Maternal-Fetal Specialist Required?
There is a litany of complications for which a maternal-fetal specialist may be required.
In order to anticipate possible problems, a specialist may be required when one or more of the following occurs during a pregnancy:
- Advanced maternal age (mother over 35 years old)
- Prior abortions or other abdominal surgeries
- Twins, triplets, or other multiples
- Several prior miscarriages
- Complications in prior pregnancies, including preeclampsia, eclampsia, and preterm labor
- Expected macrosomia (large baby)
- Family history of genetic disorders
- Substance abuse
- Diabetes
If you had any high-risk medical conditions and your doctor did not assign a maternal-fetal specialist to your care team, contact our attorneys at The Becker Law Firm. We can help you to determine if a specialist should have been monitoring your pregnancy and labor.
