Legal: Uterine rupture during VBAC

A 32-year-old woman was admitted in labor to a Pennsylvania hospital in 2003 and expected to have a vaginal birth after cesarean. During labor she was given an epidural and had several episodes of hypotension, nausea and vomiting, and some FHR decelerations. She was treated with ephedrine and eventually the obstetrician realized the external monitor was recording the maternal rather than the fetal heart rate. A fetal scalp monitor was placed and the FHR was 60 bpm. An emergency C/S was then performed. The uterus was ruptured and the fetus stillborn.

The woman sued those involved with delivery and alleged she was not properly monitored for signs of uterine rupture, the FHR was not appropriately monitored, and thus she was not timely delivered. She claimed she exhibited symptoms consistent with uterine rupture and they failed to properly respond to them.

The defense claimed that she did not have classic signs and symptoms of uterine rupture and that when the FHR was determined to be in the 60s they responded appropriately. The jury found the obstetrician at fault, but not the hospital. Damages were assessed at $895,000.