Birth Injury & Pregnancy Claims

Introduction to Birth Injuries and the Birth Injury Unit (BIU) at Applebys.

No one would question the fact that the delivery of a baby is a precious moment in the history of a family and more so for the parents of the baby. This is a time for the clinicians to shine and almost without exception that’s exactly what happens. In the UK we are blessed with some of the most experienced and well trained professionals that exist in midwifery, obstetric, gynaecological and neonatal medicine. If things go wrong though, the consequences can be catastrophic. Underneath you will find a brief list of typical Birth Injury related problems that we are familiar with and are regularly instructed on. We are of course continuously being fed information about new actions and if you don’t find an exact match for your situation below, don’t worry, we will still almost certainly be able to help you

During term.

Uterine Rupture / Placental Abruption
Causation of placental abruption is not currently known but the symptoms of it are very obvious. The patient usually suffers from a heavy vaginal bleed or severe pains in her back or abdomen. Uterine rupture is often caused in some labours, especially if it has been artificially induced and not properly monitored. Blood loss follows from the placenta separating from the wall of the uterus which then starves the baby of oxygen. Time is of the essence when making a diagnosis here and without quick treatment the effects can be severe indeed.

Pre-Natal Infections.
Many mothers suffer from infections during their pregnancy and many, if detected and treated in time, are utterly harmless to the unborn child. Some infections though, if left untreated can pass on to the unborn child either through the placenta or during birth. Regular monitoring of the mothers blood and urine is required and early detection and treatment of the infection is essential.

Maternal Diabetes / Gestational Diabetes.
Maternal diabetes / gestational diabetes is a condition which develops during term. Typically a failure to undertake a screening test, given a family history or indicative symptoms is the issue here. Regrettably this failure to spot it early can lead to miscarriage or birth defects. It can also indirectly affect birth safety as the unborn infant frequently grows to a large size.

Pre Eclampsia
Pre eclampsia is a life threatening condition and can only really be detected by use of regular urine and blood testing. Pre eclampsia is caused by a defect within the placenta, it can only be effectively cured by delivering the baby but sometimes the condition is capable of management if baby has not developed sufficiently to be delivered safely.

Wrongful Birth Cases
Here a condition such as Spina Bifida, club feet, holes in the heart and Down's Syndrome, arise; usually as a consequence of pre delivery conditions which should have been visible or at least detectable to the clinical staff, have in fact, been overlooked. The implication is that the mother, had she known of the condition, would have terminated that birth. Some of these defects are much easier to diagnose than others. If the medical team fails to diagnose a birth defect which could have been appropriately diagnosed then a wrongful birth claim could follow.

During labour.

Cerebral Palsy
Essentially caused by a lack of oxygen to the brain, this can arise in numerous circumstances and in most cases will be subject to a high degree of clinical expert evidence. CP cases are very complex but the compensation is usually very high as the family often has to contend with the circumstances of a child which has permanent disability and lack of function.

Episiotomy and Second or Third Degree Tears.
An episiotomy is a surgical applied incision to ease delivery. It is only made if the baby is in distress or if the risk of skin tear is very high. If performed correctly the episiotomy is not problematic. If done incorrectly or in some cases not at all then this could lead to second degree or third degree tearing of the skin or other complications such as incontinence. The implications are obvious and here the duty is clearly on the clinician to make the right judgment.

Erb's Palsy or Brachial Plexus Injuries
The size of the baby should be subject to monitoring throughout the pregnancy. Clinicians should make appropriate plans for the birth. If the baby is much larger than normal or the mother is not suitable for vaginal birth and they suspect problems they should be prepared to carry out an episiotomy or a caesarean section. In cases where no action is taken and the baby is large, his or her shoulders can become stuck which is very dangerous and can lead to death.
Even if the baby's shoulders are eventually freed and he or she is delivered vaginally, the trauma to the shoulders may have caused an injury to the nerves meaning that the arm or hand could be paralysed (shoulder dystocia).

Forceps Delivery or Ventouse Delivery
If the baby becomes distressed, assistance is sometimes appropriate to speed a smooth birth and a decision needs to be made between forceps or a ventouse delivery. Each method should only be used in specific circumstances and it is the inappropriate use of each method that can result in damage and scarring to the baby and mother.

Post birth.

Congenital Hip Dysplasia
A condition of the hip joint thought to be of genetic origin. All new-born babies are due to be screened for congenital hip dysplasia, and checks are required to be made at 6 months and when other development checks are carried out. If CHD is found early the prognosis is good. If not diagnosed before the baby starts to walk, the prognosis is poor indeed. Further surgery is likely to be only partially effective and problems are likely to ensue in later life.

Retained Placenta.
Following the birth of a child, the placenta will need to be delivered and thoroughly examined by the midwife. It is important that all of the placenta is delivered as retained placenta can lead to post partum haemorrhaging which can be life threatening.

Baby Examination.
Within the first 72 hours of life and usually prior to being discharged from hospital every child will have a head to toe examination; this is to detect any abnormalities which may require additional treatment such as cataracts, Cleft Pallet, tongue-tie syndrome, heart murmurs, infections, Down’s syndrome, clubfoot (talipes) plus many more. The Examination itself is sometimes overlooked and more frequently, hastily or badly performed leading to a delay in treatment of often serious conditions.