Today’s discussion, we will focus on a prolonged labor, a uterine rupture, and a baby’s HIE brain injury. At the conclusion of this post, you should have a better understanding of all three of these concepts. In addition, we are having this discussion in the context of a woman having a previous C-section and now requesting a vaginal delivery. Most of the literature suggests that a vaginal delivery following a previous C-section is usually safe. With that said, there are issues that can arise, and the procedure is not 100% guaranteed for success.
I am not here to tell you that all trial labors after a C-section and attempted vaginal births after a C-section are bad. You must do your homework and talk with your doctors about whether this is something for you. But having all the relevant information can allow a family to make the best decision for their situation.
Prolonged Labor, A Uterine Rupture, And A Baby’s HIE Brain Injury
Before getting deep into the discussion let us define the term prolonged labor. Depending on the literature that you read in general, a prolonged labor is going to be a labor that goes on for 20 hours or more from the start of contractions. Some people call prolonged labor, stalled labor or labor that fails to progress. Either way a prolonged labor can be extremely problematic in the context of a woman that has had a previous C-section and is now attempting a vaginal birth following that previous C-section.
Prolonged labor can be an increased risk factor for a uterine rupture. This is because during prolonged labor an increased amount of pressure is placed on the uterus. There is already going to be stress and pressure on the uterus during a “traditional” labor and delivery, but a prolonged labor can add more pressure because of the duration.
A uterine rupture is exactly what it says. The uterus ruptures, and this can create an obstetrical emergency. One of the main areas of concern with a uterine rupture is hemorrhaging. Depending on the severity of the rupture hemorrhaging can be life-threatening to the mother and baby. If the hemorrhaging cannot be controlled, then in some cases, the mother and the baby can die.
The term, HIE or hypoxic, ischemic and encephalopathy is a reduction or cut off of oxygenated blood, which can lead a baby to suffer a traumatic brain injury. It stands to reason that because the baby is connected to mom, if mom is hemorrhaging and losing a lot of blood, then this will adversely impact the baby. Because of mom’s hemorrhaging this and some cases lead to a reduction of cut off of oxygenated blood for the baby which can lead them to suffer in HI brain injury.
This is why it is imperative that doctors and nurses pay close attention to mom during labor and delivery, especially if she has had a previous C-section and she’s attempting a vaginal delivery. Some of the areas in which doctors and nurses must pay attention to is mainly the complaints of mom. Is mom complaining about abdominal pain or other types of pain and if so what are the doctors and nurses doing in regards to the pain? In addition, the readings on the electronic fetal heart monitor can also be important as the monitor will look at things like mom’s contractions. Is she having too many contractions over a given timeframe? Also, what is the baby’s heart doing during labor? How does variability look? Is the heart rate too high or too low? Are there prolong deceleration patterns for the baby?
All of the things that I mentioned in the above paragraph are critical to what is happening during labor and delivery for mother and baby. When a family contacts us with questions as to how their baby suffered this HIE brain injury these are the types of things, and more, that a birth injury, lawyer like me is going to assess.
If you have more questions about why your baby suffered an HIE brain injury at birth I invite you to contact me at my information below. Remember it does not cost you any money to talk with me initially about your baby’s story. This is what we do.
Marcus B. Boston, Esq.
9701 Apollo Dr. Suite 100
Largo, Maryland 20774
301-850-4832
1-833-4 BABY HELP