Page 37 - OB Risks - Delivering the Goods (Part Two)

SVMIC Obstetrics Risks: Delivering the Goods

At all deliveries, if a section of the umbilical cord is double-

clamped and set aside, it is usually stable for pH and blood gas
analysis for up to 60 minutes. If a serious problem occurs with

the infant during this period of time, blood should be drawn from
the segment of cord and sent to the laboratory for analysis.
58

When submitting a placenta for pathological evaluation,

information regarding the gestational age and pregnancy history
should be provided by the delivering physician, on a pathology

requisition sheet, or through narrative documentation. Whether
by form or narrative documentation, the clinical history provided

should be complete. The clinical history usually includes the
gestational age, any systemic issues or disorders in both mother

and child, and any complications during the pregnancy.
59 60

If an unfavorable outcome occurs, hold a review with all

healthcare participating team members to carefully outline
the sequence of events based on the notes that were

recorded as the event occurred, and document carefully. It is
strongly advised that any such meeting be conducted in

conjunction with the risk manager of the facility so the
discussion can be protected. A forensic evaluation of the

placenta may help the patient and doctor to understand what
went awry and may provide information the patient and doctor

can use to avoid the same results in a subsequent pregnancy.

58 https://www.ncbi.nlm.nih.gov/books/NBK545290/
59 The structure and utility of the placental pathology report, Gitta Turowski, W. Tony Parks, Susan
Arbuckle, Anne F. Jacobson, Alexander Heazell. First published: 24 July 2018
60 https://doi.org/10.1111/apm.12842

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