Fetal Heart Rate Monitoring and Fetal Distress
A common cause of cerebral palsy and other birth injuries due to obstetric malpractice is failing to recognize and act upon abnormalities on the fetal heart rate tracing. Fetal heart rate monitoring is an extremely important part of obstetric care, and every obstetrician, family practitioner, midwife and obstetric nurse providing care to patients in labor and delivery is required to know how to read a fetal heart rate tracing.
Patients in labor are typically connected to a fetal heart monitor that records a baby’s heart rate and corresponding uterine contractions. The baby’s heart rate changes in frequency and uniformity from minute-to-minute referred to as “variability”. The variability results present normally in a jagged appearance on the line recording the baby’s heart rate.
A constellation of findings on the fetal heart tracing is used to help make sure the baby is receiving enough blood and oxygen, is tolerating labor, and that it is safe to allow labor to continue. At times during labor, as a result of any of a number of conditions that are not readily identifiable, an unborn baby will receive inadequate blood flow and oxygen through the placenta. The baby is usually able to tolerate this for varying periods of time. Eventually, and usually after the start of contractions, the baby’s reserves become depleted. Consequently, the baby starts to accumulate acid in its blood. Unless this is corrected, acid accumulates in the baby’s tissues, causing damage to the brain and other organs, including the kidneys, liver, and heart. This is called “asphyxia”.
Babies who are born asphyxiated may have low Apgar scores (0-5), a “neonatal neurological syndrome”, with lethargy, vital sign abnormalities, and sometimes seizures. Very severe asphyxia can cause death of the baby while still in the womb, or in the first few days or weeks of life. If a baby who had birth asphyxia survives, the child usually develops cerebral palsy.
The purpose of fetal heart rate monitoring is to prevent birth asphyxia. As asphyxia develops in the womb, the fetal heart rate tracing will typically show progressive abnormalities such as decreased variability, absence of “accelerations” (short increases in the fetal heart rate, often in association with fetal movement), the fetal heart rate being too fast or too slow, or decelerations (drop in the fetal heart rate in association with contractions). The development of these findings on a fetal heart tracing is sometimes referred to as “fetal distress”. Fetal distress requires interventions such as giving oxygen and fluid to the mother, and turning her on her side to improve blood flow to the uterus and the placenta. If these do not work within a short period of time, prompt cesarean section delivery may be necessary. Delay in performing the cesarean section may result in the baby sustaining devastating brain damage.
In consultation with obstetricians, perinatologists, pediatric neurologists, midwives, obstetric nurses, pathologists, pediatric neurologists, life care planners, economists and other professionals, the lawyers at the Sweeney Law Firm will work with medical specialists to analyze prenatal records, labor and delivery records, newborn and pediatric records, imaging studies including ultrasounds, CT scans and MRIs of the brain and other sources of information to determine if malpractice occurred. If so, Sweeney Law Firm may be able to recover damages to compensate your baby for his or her emotional and physical pain and suffering, disability loss of quality of life, lost income as well as compensation for the tremendous cost of rehabilitation, physical and occupational therapy, medical and nursing care which may be required to give your child the best chance to maximize his or her abilities.
Call the Sweeney Law Firm at 260-420-3137, or toll free at 1-866-793-6339. Get answers to your questions. Learn your legal rights. There is no cost or obligation for us to evaluate your case.
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