Mary’s* Story: A Life Changed After PVL Brain Injury at Birth
*Names have been changed to protect the family’s privacy.
What Happened
Mary’s mother, Rosie, was just 28 weeks pregnant when she started experiencing heavy bleeding and contractions in the early hours of the morning. After arriving at their local maternity unit, doctors confirmed that Rosie was in labour and connected her to a CTG to monitor the baby’s heart rate. At that time, the CTG was satisfactory and the doctor made a plan to aim for a vaginal delivery. Despite the heavy bleeding and signs of abnormal CTG in pregnancy showing that the uterus was contracting very frequently, Rosie was not given a choice of delivering her baby by caesarean section.
By around lunchtime, more bleeding occurred and a scan showed the baby to be in a transverse position, meaning that vaginal delivery would no longer be possible. Rosie was therefore transferred to theatre for an emergency caesarean section. A further scan was performed and showed the baby had moved back into a ‘cephalic’ (head down) position and the Consultant therefore reversed the plan for a caesarean section and told Rosie she would now need to deliver vaginally. An artificial rupture of membranes ‘ARM’ was performed in an attempt to speed up the labour. Before Rosie could be moved back to the labour ward, the CTG showed that the baby’s heart rate was dropping, indicating that she was now in distress. Once again, a decision was made for an emergency caesarean section.
Just before the caesarean began, the Consultant left the operating theatre, handing the complex procedure over to a less experienced doctor. After multiple failed attempts by the junior doctor, the consultant was crash bleeped back to theatre. He used forceps and significant physical force to deliver Mary who was born extensively bruised, injured, and rushed to NICU.
Brain scans in her early neonatal period showed she had sustained a PVL brain injury, diagnosed as cystic Periventricular Leukomalacia. As a result, she has severe quadriplegic cerebral palsy.
Understanding PVL and Cerebral Palsy
PVL and cerebral palsy are closely connected conditions that can result from oxygen deprivation or blood flow disruption to a baby’s brain during pregnancy or birth. Periventricular Leukomalacia (PVL) is a type of brain injury affecting the white matter around the brain’s ventricles, which is particularly vulnerable in premature babies. When this delicate brain tissue is damaged due to inadequate oxygen supply, it can lead to the development of cerebral palsy; a condition affecting movement, muscle tone, and posture.
In Mary’s case, the PVL brain injury occurred due to disrupted blood flow and oxygen to her developing brain during the traumatic delivery.
The Claim
CL Medilaw were approached by Mary’s parents to review the case and provide a second opinion after her claim was discontinued by another firm of solicitors due to what they were told was unsupportive evidence from experts.
We reviewed the evidence and, after properly listening to her parents’ concerns about the care they’d received, we were able to re-open the case and obtain fresh expert opinions that supported that there had been negligent care at Mary’s delivery that caused her brain injury. The experts considered that Rosie had not been given adequate advice about her birth options when she first presented to hospital with the bleeding, and should have been offered a caesarean section straightaway. There were then concerns that once the initial plan for a caesarean section was made and mum was transferred to theatre, it should never have been reversed back to one for a vaginal delivery, particularly when the CTG had started to show signs that Mary was in distress. The experts also considered that there was a delay in responding to the CTG abnormalities, and that once the emergency caesarean section was underway, the Consultant should have performed it himself which would likely have avoided the traumatic brain injury.
Mary’s PVL brain injury was thought by the experts to have been caused by a placental abruption causing a disruption to the blood flow and oxygen to her brain, and that earlier, competent delivery would have avoided or very much reduced her injury.
After years of legal battle with the hospital Trust, who for a long time failed to respond to the claim, the case was fully admitted. It was accepted that the Consultant should never have left the operating theatre during the caesarean section and, but for this breach of duty, Mary’s injury would have been avoided or much reduced.
Mary was therefore able to obtain a court judgment in her favour, securing crucial compensation to provide her with the care, therapy, housing and other life changing support she and her family will need for the rest of her life.
Changing Lives
Mary is a bright, joyful girl who loves shopping (especially for shoes!), reading and playing basketball with her big brother, and going to the cinema. With our help, her family has been able to access the care and resources they so urgently needed. They have the funds to purchase a larger, more suitable home that can be adapted to meet Mary’s complex needs, and Mary has been provided with new wheelchairs, equipment and therapies, without the need to rely on the local authority for funding.
Mary now receives regular physiotherapy, occupational and speech therapy, and has a large annual payment of funds for support workers to provide her care, giving Mary’s parents’ some respite and also time to focus on being her parents, not just her carers. Most importantly, they now have peace of mind. Mary’s damages award ensures her future is protected, she will be looked after with care and compassion, and she will have access to the best opportunities to live her life to the fullest.
FAQs About PVL and Cerebral Palsy
Q: What is periventricular leukomalacia (PVL)? A: Periventricular Leukomalacia (PVL) is a type of brain injury that affects the white matter surrounding the brain’s ventricles (fluid-filled spaces). It occurs when brain tissue is damaged due to reduced blood flow and oxygen, which is particularly common in premature babies. The damage creates small holes or cysts in the white matter, which can lead to developmental difficulties and cerebral palsy.
Q: What is the difference between PVL and CP? A: PVL and cerebral palsy are related but distinct conditions. PVL is the actual brain injury: the damage to the white matter of the brain. Cerebral palsy (CP) is the resulting condition that affects movement, posture, and muscle control. Not all cases of CP are caused by PVL, and PVL can sometimes occur without leading to CP, though they are frequently connected, particularly in premature babies but sometimes also in babies born closer to term.
Q: What causes cerebral palsy during pregnancy? A: Cerebral palsy during pregnancy can be caused by several factors including infections, disrupted blood flow to the baby’s brain, placental complications (like placental abruption), oxygen deprivation, premature birth, and complications during delivery. In many cases involving PVL and cerebral palsy, the condition develops when the baby’s brain doesn’t receive adequate oxygen and blood supply during a critical period of development or during birth.
Q: Does PVL always lead to cerebral palsy? A: No, PVL brain injury does not always lead to cerebral palsy. The outcome depends on the severity and location of the brain damage. Some children with mild PVL may experience minor developmental delays or learning difficulties, while others may develop more significant disabilities including cerebral palsy. Severe or cystic PVL, like in Mary’s case, has a higher likelihood of resulting in cerebral palsy.
Q: What are early signs of PVL? A: Early signs of PVL brain injury can include abnormal muscle tone (either too stiff or too floppy), feeding difficulties, developmental delays, vision problems, and seizures. PVL is typically diagnosed through brain imaging such as ultrasound or MRI in the days or weeks following birth, particularly in premature babies or those who experienced complications during delivery. Parents may notice delays in reaching developmental milestones such as rolling over, sitting, or crawling.
We’re Here to Help
If your child has been diagnosed with PVL and cerebral palsy following complications during pregnancy or birth, CL Medilaw’s specialist birth injury solicitors are here to support you. We understand the profound impact these injuries have on families, and we’re committed to helping you access the care, support, and answers you deserve.
Contact us today for a free, confidential consultation to discuss your family’s experience and explore how we can help secure your child’s future.
