The placenta is a vital organ ensures that your unborn child receives sufficient nutrients, oxygen and antibodies to fight infections; it also acts to transfer your babies waste back through the placenta into your blood stream and produces a range of hormones that are important during pregnancy.
Following the birth of your child, the placenta needs to be delivered. This is commonly known as the third stage of labour and usually occurs within 30 minutes of delivering your child. If the placenta cannot be delivered within this timeframe then it may have to be surgically removed. According to the Midwifes Rules and Standards (NMC 2004) it is the responsibility of the midwife to provide the care required to ensure that the placenta and membranes are delivered and to identify whether the membranes are complete, incomplete or ragged. A failure to appropriately identify and specify the status of the placenta could amount to a breach of duty and has the prospects of a successful claim for damages.
The main known causes for retained placenta are:
Adhesions of the Placenta (Adherent Placenta). The placenta can stick to the wall of the uterus and as a result be prevented from separating and therefore being delivered. Adhesion of the placenta is more common in women who have previously undergone Caesarean Section, however it can occur in all deliveries.
Placenta Accreta. This commonly occurs in women who have had previous caesarean sections. The placenta attaches to scar tissue or the muscles lining the uterine wall instead of the uterus. Placenta Accreta can be detected at ultra sound scan in the second or third trimester. Treatment is available and delivery of your child and the placenta should always take place by way of caesarean section.
Uterus not Contracting. The placenta separates from the uterus when the uterus contracts. If the uterus does not contract then the placenta cannot separate. Weaker contractions may lead to a partial separation of the placenta. The treating midwife should be able to identify the strength of the contraction and if the contractions are weak and there is a possibility that the placenta may not detach then medication may be implemented to assist delivery.
Emotional Reasons. Fear, stress, happiness and anxiety are emotional reactions that most women experience following the birth of their child. With an overwhelming emotional reaction, the body can produce adrenaline; this may cause the contractions to stop, preventing the separation of the placenta.
There is no known way to determine prior to birth whether the placenta will be delivered complete and there is no known medication that has proven effective to help eliminate the risk of retained placenta.
Retained placenta is identified following delivery where the membranes are classified as incomplete or ragged. The risks associated with a retained placenta include postpartum haemorrhaging and infections and can be life-threatening. Studies have shown that approximately 18% of new mothers suffer from one form of retained placenta or another.
Once identified, the midwife/obstetrician may be able to remove the retained placenta by way of controlled cord traction (manually pulling the retained placenta out by grasping the cords), if this fails, manual extraction will be required either vaginally or by surgical intervention. In any event the placenta needs to be removed fully.
If there has been a failure to identify that the placenta was not delivered complete or a failure to attempt removal within a required timeframe then this may give rise to a claim. Also if there was a failure to diagnose Placenta Accrete at ultra sound scan and/or a failure to implement an appropriate treatment plan, compensation may be due.
Applebys Solicitors Clinical Negligence team have a wealth of experience in handling birth injury claims. We will ensure that the claims process if as swift and problem free as possible. Our All Female Team are highly experienced and offer a professional, approachable and sympathetic service to all of our clients.
If you feel you have been the victim of clinical negligence and have suffered from retained placenta then call our all-female team now on 0800 1691325 and to discuss your circumstances and we will provide you with confidential advice.
Case Study Our client went into natural labour and the placenta and membranes were delivered by controlled cord traction. The treating midwife documented that following examination, the placenta and membranes were healthy and complete. Our client began to bleed vaginally and collapsed to the floor. Blood clots were found in her uterus and retained placenta was identified. Our client required surgical intervention to remove the clots and the retained placenta. Vaginal tears were also sutured at this time. Applebys Birth Injuries Unit successfully achieved £15,000.00 in damages for our client.
Contact Applebys all female team for a free initial chat on 0800 169 1325 or e-mail enquiries@applebys-law.co.uk.