Page 32 - OB Risks - Delivering the Goods (Part Two)
P. 32

SVMIC Obstetrics Risks: Delivering the Goods




                 Document all interpretations, interventions, plans of care, and
                 patient informed consent discussions carefully and thoroughly

                 in the medical record. Include signed informed consent
                 forms. Complete, specific, and documented informed consent

                 discussions are invaluable to a defense.


                 If it is determined during prenatal care that the patient may

                 be at risk of shoulder dystocia, the patient’s labor progression
                 should be followed closely for indications of difficulty. As always,

                 it is essential that the physician accurately document the
                 management of labor and any delivery complications.



                 Risk factors for a potential shoulder dystocia may include

                 induction of labor, epidural anesthesia, prolonged second
                 stage labor, and operative vaginal delivery.  If the obstetrician
                                                                           54
                 suspects the baby is heavier than normal, and the patient’s labor
                 is not progressing normally, the obstetrician should be ready for

                 an impending shoulder dystocia. A protracted active phase of
                 labor, secondary arrest of labor, or prolonged second stage of

                 labor should be interpreted as signs of an abnormal labor.
                                                                                                55

                 In the event of an injury to the infant, review the delivery with

                 the patient, including the previously known risks for shoulder
                 dystocia, the sequence of events at delivery, the actions that

                 were taken during the delivery, and why the actions were
                 taken. Document the review in the medical record. If the infant

                 is requiring more assistance than usual, consider consulting
                 the infant’s attending physician as to the infant’s status and








                 54     https://www.researchgate.net/publication/51798202_Critical_analysis_of_risk_factors_for_
                        shoulder_dystocia
                 55     Id.

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