Amniotic Fluid Volume and Fetal Growth Indicate Fetal Wellbeing During Pregnancy

Christopher Nyberg and Bradley Zimmerman recently obtained a settlement in Orange County for a 28-year-old mother who unfortunately experienced a stillborn birth of her first child due to the failure of the Defendants to diagnose placental insufficiency and to deliver her baby early before he passed away.

Mr. Nyberg and Mr. Zimmerman successfully proved that our client’s medical providers failed to properly monitor and identify irregularities in the mother’s amniotic fluid and fetal growth rate, which would have indicated that the mother and her baby needed elevated attention and care.

At the Jacob Fuchsberg Law Firm, our team of New York Amniotic Fluid Birth Injury Attorneys will help you and your loved ones recover justice.

Our Client’s Story: Mother’s Alarming Amniotic Fluid Levels and Decreased Fetal Growth Overlooked During Pregnancy

The mother became concerned over the course of her pregnancy when she felt her belly was not growing as large it should be as the weeks went by. At a visit at 31 weeks, the examining midwife negligently failed to properly measure and document the mother’s uterus size, otherwise known as Fundal Height.

Fundal Height is a gross way to determine if the baby is growing appropriately. Measurement of Fundal Height should be done at every appointment, and failure to do so is a departure from the Standard of Care.

Despite the fact that her midwife neglected to measure her fundal height, the mother took care into her own hands and pressed the midwife to order an ultrasound as she was concerned about growth. 11 days later, the mother underwent the “growth ultrasound”; however, unfortunately, the Defendants failed to properly conduct and read this ultrasound:

• They failed to take and look at images to objectively measure the amniotic fluid by either measuring the Amniotic Fluid Index (“AFI”), the measurement of the total amniotic fluid in the four quadrants, or Deepest Vertical Pocket (“DPV”) by measuring the quadrant with the greatest amount of amniotic fluid.
• They failed to see that subjectively the amount of amniotic fluid had gone down from the last ultrasound (a concerning sign).
• They failed to recognize the significance of the substantial drop-offs in the baby’s growth, specifically the Abdominal Circumference (“AC”) measurement, which had alarmingly decreased by 76%, and the Estimated Fetal Weight (“EFW”), which had decreased by 65%.

Although the percentiles did not technically qualify as an Intrauterine Growth Restriction (“IUGR”), they were substantial drop-offs and indicated a strong possibility of placental insufficiency.

Defendants failed to recognize reduced amniotic fluid and substantial drop-offs in fetal growth as two key warning signs of placental insufficiency, which should have raised concern for fetal wellbeing.

The Defendants should have timely ordered additional testing, including Doppler Velocimetry (to measure blood flow through major fetal blood vessels) which can show placental insufficiency and inadequate blood supply and nutrients to the baby, Biophysical Profile (“BPP”) to measure fetal tone, breathing, movement, and amniotic fluid, Non-Stress Test (“NST”) to look at the fetal heart rate, and additional growth ultrasounds to see if the EFW and AC continued to worsen.

If these tests were performed, they would have shown that the mother’s baby was getting worse and would have indicated a need to urgently deliver the baby before anything bad happened.

Unfortunately for the mother, the Defendants failed to do any of this, and she suddenly lost her baby at 34 weeks, an outcome that would have been preventable with proper diagnosis and testing.

Amniotic Fluid Volume and Fetal Growth Indicator of Fetal Well-Being During Pregnancy

During pregnancy, Amniotic Fluid Volume levels and fetal growth, specifically AC and EFW, are two of the most important indicators of fetal well-being, especially in the 2nd and 3rd trimester.

Amniotic Fluid Volume should be measured at almost every 2nd trimester and 3rd trimester ultrasound and has been called an “indispensable adjunct to antenatal and intrapartum fetal assessment” because the measurement provides “important information regarding fetoplacental function and feal anatomic integrity.” [1]

Similarly, fetal growth indicates how the baby is doing and if the baby is getting adequate nutrients and oxygen through the placenta. If the blood flow and nutrient flow is inadequate, the baby will shunt and direct oxygen away from growth and to the most important parts of the body, namely the heart and brain instead, which is reflected by decrease EFW and AC levels.

If the baby also stops growing or falls of the growth chart in conjunction with decreased EFW and AC levels, it is an indication of placental insufficiency and insufficient blood flow and nutrients reaching the baby.

It is your medical provider’s responsibility to consistently assess and monitor the baby’s amniotic fluid levels to ensure that they baby is growing adequately throughout pregnancy.

If there is any indication that the baby is not growing at a normal rate, whether it be through the mother’s belly growth or the baby’s amniotic fluid levels, your provider must take action immediately, otherwise your baby’s health may be at risk.

Speak with a New York Stillbirth Injury Lawyer

Our office deposed every provider involved end exposed the Defendants’ numerous failures. As a result, our experienced New York birth injury attorneys brought the case to settlement after completing discovery.

The case was successfully resolved during mediation to at least give the mother some closure for her baby who tragically cannot be replaced.

If you or a loved one have experienced a stillbirth due to your provider’s failure to attend to irregular test results during your pregnancy, speak with a New York Stillbirth Attorney at the Jacob Fuchsberg Law Firm today to hold the responsible parties accountable.

We can help when the unimaginable happens.

Citations

[1] Magann EF, Sandlin AT: Amniotic fluid and the clinical relevance of the sonographically estimated amniotic fluid volume, J. Ultrasound Med 2011;30s:1573-1585.

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