Uterine Rupture Can Lead to Cerebral Palsy
Uterine rupture is a rare and often-catastrophic obstetric complication with a high rate of fetal morbidity. It’s vital for doctors to identify uterine rupture as soon as possible in order to avoid potential brain damage to the baby, or the death of the mother or child.
In simple terms, a uterine rupture involves any kind of a tear in the wall of the uterus, and usually occurs during active labor. The location of the rupture is usually along the scar tissue present from a previous cesarean section, but this is not always the case.
The uterine wall consists of three layers: the endometrium, the myometrium, and the parametrium. When the uterine wall ruptures completely, the contents of the uterus spills into the peritoneal cavity, which causes an internal hemorrhage.
An incomplete rupture is called a uterine dehiscense, and though a window may form in the uterus, the thick myometrium layer stays intact. In this particular scenario, the baby remains within the confines of the uterus and their oxygen supply is uninterrupted.
A uterine rupture event allows the baby to be pushed out of the uterus, which ultimately leads to a separation of the placenta from the uterus (placental abruption). Without any connection between the placenta and the uterus, it is impossible for the baby to receive any oxygen. A lack of oxygen to the baby’s brain can result in hypoxic ischemic encephalopathy and permanent brain damage in the matter of minutes. This damage to the brain can ultimately result in the development of neurological disorders such as cerebral palsy.
Facts and Statistics
Uterine ruptures are actually quite rare (about 1 in every 1,400 pregnancies), especially for women who have never had a c-section, another type of uterine surgery, or previous rupture.
An incomplete uterine rupture is not always a medical emergency; not only that, it doesn’t always necessitate a cesarean delivery. In fact, many dehiscenses actually remain undetected and heal without any medical intervention.
Once a uterine rupture has occurred, the general consensus is that the baby must be delivered as soon as possible. If the baby is not delivered within about 15 minutes, the child is likely to experience catastrophic brain damage. After 30-35 minutes, fetal morbidity becomes almost inevitable.
According to the American Pregnancy Association, around 90 percent of woman who have undergone C-sections may be candidates for VBAC (Vaginal Birth after Cesarean), but only approximately 82 percent of term deliveries are successful (74 percent for pre-term births).
Cause of Uterine Rupture
Although a uterine rupture is rare, when it does occur, the cause is usually the stress of the contractions. The scar tissue from a previous C-section should grow and stretch naturally with the progression of a new pregnancy, but unfortunately, the rigors of labor can cause the uterine wall to stretch thin enough to cause failure if the labor is prolonged or intense.
The contractions can become even more violent and much stronger if labor-inducing drugs such as Pitocin are used. In addition, the use of drugs to soften the cervix in order to induce or improve dilation also leads to an increased risk of uterine rupture.
Some of the signs a mother has suffered a uterine rupture include the following:
- Reduction of the fetal heart rate (bradycardia)
- Pains in the mother’s abdomen, or a dramatic change in the appearance of the abdomen due to the fetus moving outside the uterus
- Excessive vaginal bleeding
- Slowing or cessation of labor
- Signs of shock
- Rapid pulse
Cerebral Palsy that Occurs from a Uterine Rupture
When a complete rupture occurs, the fetus is more than likely to suffer from an inadequate blood (oxygen) supply. This results in hypoxia, which can lead to brain damage in the matter of minutes. Any type of brain damage or malformation of the brain occurring before, during, or shortly after the birth of the baby can result in the development of cerebral palsy.
Failing to identify uterine rupture and mitigate harm to the child could be considered medical malpractice, but this can be a tough standard to prove without the help of a cerebral palsy attorney. Not all cases of cerebral palsy are caused by medical malpractice, but there’s no harm in seeking out a free attorney consultation and having them look into the facts of your case.