Page 25 - OB Risks - Delivering the Goods (Part Two)

SVMIC Obstetrics Risks: Delivering the Goods

particularly in comparison to her previous pre-labor
blood pressures. There was no laboratory evaluation

of this and no urine protein until after delivery, at which
time it was 1+ and there was no blood evaluation nor

was there any mention of edema. The patient should
have been given magnesium sulfate during labor and

delivery as soon as the she was stable and it was
feasible to do a C-section.

4. There were non-reassuring fetal heart tracings

well before the 9:08 pm final change in tracing. As
early as 5:30 pm, there was a significant change in
variability. Variable decelerations began occurring and

worsened about 8:35 pm. Then at 9:14 pm, there was

a 6-minute loss of fetal heart tracing entirely. There
was bradycardia and then eventually loss of the fetal
heart tracing.

5. Insufficient progress notes were made in the hospital

record; the documentation recorded by the two
covering OBs was poor.

6. An order sheet on the hospital record related to the
VBAC was entirely blank, so there was no apparent

informed consent that occurred during the hospital
stay related to the VBAC. Moreover, the documentation

by the regular OB relating to VBAC risks was deficient.

7. She was a high-risk patient for uterine rupture and

appropriate precautions were not in place.

8. A change in the amniotic fluid indicated fetal stress

and the baby began to have meconium; there was no

response to these conditions.

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