Hemorrhage/ Bleeding

In many labor and deliveries, it’s not unusual for a baby to suffer swelling and bruising to the head. That’s because when a baby passes through the birth canal, the head inevitably suffers some degree of trauma. Most of the time, these issues will resolve on their own without intervention.

However, when complications arise during labor and delivery, it can result in greater trauma to the baby’s head. As our Boston birth injury lawyers at Jeffrey Glassman Injury Lawyers know, some of situations may include:

• Prolonged labor
• Baby large for gestational age
• Baby’s head will not fit easily through pelvis (cephalo-pelvic disproportion)
• Breech position of fetus

In these situations, it is imperative for doctors and other health care workers to keep a close watch for any signs of fetal distress. It may also be necessary to initiate an emergency C-section to reduce the chances of an intracranial hemorrhage and bleeding, which often results in serious injury to the brain.

In some cases, medical intervention during a tough delivery can result in neonatal hemorrhaging and bleeding. The best-known example of this is the incorrect use of vacuum and forceps extraction.

These are characterized as any type of bleeding in the brain or skull of the newborn. There are several different kinds, including:

• Cerebral hemorrhage. This is a kind of stroke in which there is a bleed inside the brain.
• Subarachnoid hemorrhage. This is a bleed in the space between the two innermost membrane layers surrounding the brain. It usually results in seizures or apnea.
• Intraventricular hemorrhage. This is one of the most serious types of intracranial brain bleeds in newborns, and it occurs in the area where spinal fluid is made. It can often occur as a result of physical trauma at birth, with premature infants and those with low birth weight being especially susceptible.
• Subdural hematoma or subdural hemorrhage. This is a bleed that happens when there are ruptures in blood vessels in the subdural space, or the areas between the brain’s surface and the lawyer of tissue that separates the brain from the skull. In most cases, the cause is birth trauma. It can result in seizures, retinal hemorrhages, enlarged head and high levels of bilirubin.
• Cephalohematoma. This type of bleed happens between the skull and its covering, which typically results in a bump on the head. It can last anywhere from a few weeks to several months.

There is also the possibility of a condition known as fetal-maternal hemorrhage (FMH), which is a leakage of fetal red blood cells into the maternal circulation.

On a small scale, this isn’t associated with major problems. However, when 30 ml or more of fetal blood is lost, this may increase the risk of stillbirth. As the Journal of Trauma and Acute Care Surgery reports, this condition can be detected with a Kleihauer-Betke test, a type of blood testing.

Another cause of dangerous bleeds in newborns is hemorrhagic disease of the newborn. This is also sometimes referred to as Vitamin K Deficiency Bleeding. Newborns are naturally vitamin K deficient, as it passes poorly through the placenta and stores of it in breast milk are low. As a result, the baby may suffer from excessive bleeding at the site of the:

• Umbilicus
• Mucous membranes
• Gastrointestinal tract
• Circumcision
• Venipunctures (site of intravenous therapy)

The condition is usually treated effectively with vitamin K supplements, and many physicians will give this to newborns as a proactive measure.

For the mother too, there is always a risk of excessive bleeding. Postpartum hemorrhaging occurs when there is more than 500cc of blood loss following a vaginal delivery, or more than 1,000 cc of blood loss after a cesarean section. The Centers for Disease Control and Prevention reports hemorrhaging accounted for 11.3 percent of all pregnancy-related deaths in 2011, behind cardiovascular diseases and infection.

Common causes of postpartum hemorrhaging include:

• Trauma, usually to the cervix, clitoris, labia, uterus or vagina.
• Tissue. Retention of the placenta or other elements of birth can prevent the uterus from contracting, and this can result in excessive bleeding.
• Tone. This involves an inability of the uterus to contract, often caused by either infection or inability to dispel placenta. It’s called “uterine atony,” and it can cause severe blood loss.
• Thrombin. This is a blood disorder in which the mother is unable to form blood clots after birth.

If you, your spouse or your infant has suffered as a result of hemorrhaging or bleeding during childbirth, contact our offices today to learn more about how we can help.