Umbilical Cord Complications
The umbilical cord is the structure that connects a baby in the womb to its mother. It runs from an opening in the fetus’s stomach to the mother’s placenta in the womb. The average umbilical cord is about 20 inches long. The umbilical cord serves a critical role during pregnancy – to carry oxygen and nutrients from the placenta to the baby’s bloodstream. The cord is made up of one vein that carries blood rich in oxygen and nutrients from the mother to the baby and two arteries that return deoxygenated blood and waste products such as carbon dioxide from the baby back to the placenta.
An infant cannot survive in the womb without the umbilical cord during the gestational period. Once the baby is delivered, the cord is severed and the baby starts to breathe on its own. However, there are a number of umbilical cord problems and related complications that may occur during a pregnancy, which may subsequently put the infant at risk for serious as well as long-term birth injuries.
If your child has suffered umbilical cord related injuries that stemmed from negligence and/or improper medical supervision and care, you may be able to seek compensation for the injuries, damages and other losses. An experienced New York birth injury lawyer will be able to help you understand your legal rights and better evaluate your options.
Understanding the Umbilical Cord’s Role
The umbilical cord fulfills three separate functions:
Source of oxygen: First and foremost, it serves as a blood source for the fetus. This is especially important because the fetus is not able to breathe. While in the mother’s womb, the fetus does not have functioning lungs or an oxygen source. Therefore, the umbilical cord allows the fetus to obtain the oxygen it needs to live.
Conduit for nutrients: The umbilical cord also serves as a channel for delivering calories, proteins, fats, vitamins and other nutrients to the fetus. When the fetus is in the womb, it has no other way to get the food and essential nutrients it needs to grow and develop.
Ejecting waste products: Finally, the umbilical cord serves to transfer waste products and deoxygenated blood away from the fetus to the mother’s blood, where it can be processed and excreted.
Umbilical Cord Abnormalities and Complications
There are a number of abnormalities and complications that may affect the umbilical cord, which of course, has an impact on the health of the mother and the infant. As prenatal ultrasonography becomes increasingly advanced and sophisticated, it is possible for many of these conditions to be monitored and diagnosed in utero. Here are some of the umbilical cord abnormalities and complications that may lead to birth injuries or other complications for the baby.
Abnormal Cord length
The length of the umbilical cord varies from no cord (a condition known as achordia) to about 118 inches, which is almost 10 feet. The average umbilical cord is about 21 inches long. We don’t exactly know why cords vary in length. But, the length of the cord is believed to reflect movement of the fetus in utero. Short cords are associated with fetal movement disorders and intrauterine constraint as well as placental abruption (when the placenta separates from the wall of the uterus), cord rupture and emergency c-sections for fetal heart rate issues. On the other hand, excessively long cords are associated with fetal entanglement.
Umbilical Cord Prolapse
Umbilical cord prolapse occurs when the baby’s umbilical cord is put under pressure or compressed. This may happen either during pregnancy or during labor. Umbilical cord prolapse occurs in about one in 10 deliveries. When compression on the umbilical cord is more extreme and lasts for longer periods of time, it may end up blocking vital nutrients and oxygen from being passed on to the baby. It may essentially lead to a decrease in oxygen and blood flow to the baby.
The compression or prolapse also causes changes in the baby’s heart rate and blood pressure. If the umbilical cord prolapse occurs during pregnancy or labor, the risk of damage is determined by the extent of time the umbilical cord remained compressed. When the cord is compressed for a prolonged period of time, there is a decrease in blood flow and oxygen to the baby’s brain. This may lead to brain damage. A compressed umbilical cord may also lead to fetal hypoxia, which means that the baby is deprived of oxygen.
Umbilical cord prolapse can be diagnosed before labor by one of two tests – a fetal Doppler or an ultrasound. It may be treated by a process known as amnioinfusion, which involves introducing a saline solution at room temperature into the uterus during labor in order to relieve pressure. If the baby shows signs of distress or if the baby’s heart rate suddenly shows signs of short drops in heart rhythm, a C-section may be necessary to prevent serious birth injuries.
Nuchal Cord Complications
Nuchal cord is a term used by medical professionals when the baby has the umbilical cord wrapped around its neck. This may occur during pregnancy, labor or during birth. Here are some of the factors that may lead to nuchal cord complications:
Healthy cords are protected by a gelatinous filling known as Wharton’s jelly. The purpose of this jelly is to keep the cord knot-free so the baby will be safe regardless of its movements in the womb. When umbilical cords have insufficient Wharton’s jelly then a nuchal cord is more likely to occur. Also, mothers who have twins or multiples or have excessive amniotic fluid, or a baby who has an especially long umbilical cord are more prone to nuchal cords.
A tight and persistent nuchal cord can cut off adequate blood flow to the brain and cause brain damage or even death during pregnancy. If the cord is around the neck at delivery, it can tighten as the baby moves down the birth canal. If the cord is very tight, it might be clamped twice and cut before the rest of the baby is delivered. There will be indications that the cord is tightening during delivery with changes in the baby’s heart rate, etc. If fetal distress is detected a C-section might become necessary.
Umbilical Cord Knots
Umbilical cord knots, also known as “true knots,” form in the baby’s umbilical cord and occur in roughly one out of every 100 pregnancies. They happen most often in identical twins who share the same amniotic sac. They may also occur when babies move and turn in the womb. Since cord vessels compress when a knot tightens, these types of true knots may be extremely hazardous increasing the chances of fetal death and brain injury as a result of hypoxic-ischemic encephalopathy (HIE) or lack of oxygen to the brain.
One of the common consequences of HIE is cerebral palsy, an umbrella term that refers to a group of disorders affecting a person’s ability to move. Cerebral palsy affects people in different ways and can affect body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. People who have cerebral palsy may also have visual, learning, hearing, speech, epilepsy and intellectual impairments.
Umbilical cord knots can be detected through ultrasound. It should be standard procedure to test for knots prenatally when certain risk factors are present. Not doing so should be considered medical negligence. Because this is an extremely risky situation, it is also common to admit the mother to the hospital so she can be closely monitored for any fetal distress. C-sections often become necessary in such cases. True knots occur in about one in every 100 pregnancies. In one out of every 2,000 deliveries, the baby’s true knot actually leads to serious complications.
True knots may occur when there is excessive amniotic fluid. Knots are also associated with having had two or more children in prior pregnancies, advanced maternal age and longer than average umbilical cords.
Umbilical Cord Cysts
It’s unclear as to how or why an umbilical cord develops cysts. However, when they appear, they must be removed because they may cause serious problems for the baby. Umbilical cord cysts are out-pockets in the cord that can be detected with an ultrasound exam in the first trimester of the pregnancy. Umbilical cord cysts may be “true cysts,” which are cysts lined with cells and have remnants of embryonic structures inside. Or, they may be “false cysts” that are simply sacs filled with fluid. When large cysts occur near the umbilical cord insertion, it is important that they are closely monitored. Your doctor should ensure that the cyst is not blocking the umbilical cord blood flow. This may result in significant injury to the developing fetus.
Medical Negligence and Birth Injuries
It is noteworthy that umbilical cord complications can lead to serious and life changing birth injuries. Competent fetal monitoring and proper treatment can help prevent the birth injuries associated with such umbilical cord complications. For example, if doctors or members of the medical staff fail to properly monitor the fetal heart rate or other vital signs, they may not realize that the baby is in distress.
Loss of oxygen can lead to cerebral palsy and irreversible brain damage or even death. It is also important to understand that not all umbilical cord complications surface during labor and delivery. With careful fetal monitoring and ultrasound procedures some of these problems can be detected much earlier, which can help prevent complications down the road. The issues may become more visible as the delivery draws closer. But, if the problem is detected earlier, a scheduled C-section may help to greatly reduce chances of fetal distress and birth injury risks.
In a birth injury case, it is important to gather and preserve evidence that can help strengthen your case. Among the important pieces of evidence are your child’s medical records that would serve as a detailed account of your child’s medical condition. It is also crucial to keep copies of test results such as ultrasounds, CT-scans or MRIs. Make sure that your child’s pediatrician gives his or her diagnosis in writing.
Save all correspondence with various parties including your physician, hospital and the health insurance company. Do not directly contact the insurance company. It is best that your lawyer handles that. Save all medical bills and invoices for expenses you have incurred. These will establish the type of treatment and care your child has received and may also serve as a good predictor of the type of care your child will need in the future.
Contacting an Experienced Lawyer
If your child has suffered a birth injury as the result of umbilical cord complications and medical negligence, the experienced New York personal injury attorneys at the Law Offices of Kenneth A. Wilhelm can help you better understand your legal rights and options, and also fight hard to recover just compensation for you.
One of our clients secured a $43,940,000 verdict for a child who was diagnosed with cerebral palsy. The hospital failed to diagnose fetal distress, which led to brain damage and cerebral palsy from lack of oxygen supply to the brain. The delay in diagnosing the fetal distress and ordering a C-section delivery caused the child’s condition. Defense attorneys argued that the child’s injuries were caused by premature birth and that the obstetrical care was appropriate. The $43,940,000 verdict was eventually reduced on appeal, because the verdict was so huge.
In another case, our client obtained a $4,500,000 settlement where the doctor negligently used forceps to deliver a baby cutting oxygen supply to the child’s brain. The infant suffered from cerebral palsy as a result. We were able to prove that a C-section should have been performed, which may have prevented the cerebral palsy from occurring.
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