More women should be advised of the risks of placenta complications

The risk of complications arising from the placenta (also known as afterbirth) has increased.

This relates to an increase in the incidence of low lying placenta; placenta praevia is a low-lying placenta after 20 weeks of pregnancy, which may completely cover the cervix; placenta-accreta refers to the placenta being stuck to the muscle of the womb or other organ, eg. bladder.  The increase in the condition is as a result of the increased number of women who now have caesarean sections or have received fertility treatment.

The condition has recently been highlighted by TV presenter Amanda Holden who suffered from placenta praevia-accreta (her placenta covered the cervix) and TV personality Kim Kardashian who suffered from placenta praevia; both women have advocated for better communication to expectant mothers of the now increased risk of the condition of low lying placenta.

The change in incidence of the condition has been noted by the Royal College of Obstetricians & Gynaecologists’ (“RCOG”) who initially published guidance in 2001, 2005 and 2011.  The above link, published by RCOG on 27.9.2018, provides guidance for expectant mothers.  It is clear that this is advice which requires the information relating to the risk to be shared with expectant mothers during the antenatal period.  In the event of early notification and therefore detection, the condition can be managed by antenatal ultra sound scan and a planned caesarean section.

The risk of low lying placenta is now increased and expectant mothers should be made aware.  The case of Montgomery (Montgomery v Lanarkshire Health Board [2015] UKSC 11 heard by the Supreme Court, has cemented the principles in relation to patient consent. The case related to information provided to an expectant mother; the Claimant alleged that she had not been properly advised of all material risks which related to her choices when planning delivery of her baby.  The related law reports make clear that the paternalistic days of ‘doctor knows best’ are over and the patient must be engaged in dialogue which ensures that reasonable care has been taken to ensure that a patient is aware of the material risks which relate to their particular circumstances and the recommended treatment (as well as any reasonable alternative).

Mothers who have had previous caesarean sections or fertility treatment are at risk of low lying placenta, leading to heavy bleeding during pregnancy and delivery.  They should be aware of this and offered early care/observation as necessary to avoid later complications.

Please contact Devonshires Clinical Negligence Team who has experience of claims relating to complications and medical negligence during pregnancy or at the birth/delivery as well as experience of claims relating to negligence linked to clinicians failing to properly advise patients of the risks of proposed procedures/surgery.

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