Page 43 - OB Risks - Delivering the Goods (Part Two)

SVMIC Obstetrics Risks: Delivering the Goods

She presented to her OB’s office for prenatal care and was
found to have an estimated date of confinement of May

1st and this was confirmed by ultrasound. Throughout
the pregnancy, she saw the physician multiple times,

there was excellent monitoring, and her pregnancy was
uneventful. On April 15th, she had spontaneous rupture of

membranes and began laboring. She was admitted to the
hospital at 5:34 pm at 3 cm with 90 percent effacement.

The labor progressed nicely with epidural anesthesia
performed. There was noted to be some decreased

variability at times throughout the labor; however, the
patient continued to dilate well and reached full dilation

at 9:50 pm.

At 10:09 pm, the OB delivered the baby’s head using
a vacuum. There was noted to be one loop of nuchal

cord around the neck which was reduced by the
physician. At that time, it became evident that a shoulder

dystocia was present. Different maneuvers including a
McRoberts maneuver with suprapubic pressure, rotation

with a Wood’s screw maneuver, and then a Zavanelli
maneuver were accomplished according to the OB.

These occurred in order times three. In addition, a fourth-
degree proctoepisiotomy was performed, and the infant

delivered at 10:21 pm. The Apgars were a 0, 0, and 3 at
1, 5, and 10 minutes. The baby was resuscitated by the

pediatric intensive care team and was later transported
to the nursery. Postpartum pathology of the placenta did

not show evidence of an infection.

A lawsuit was filed, and the claims involved a left brachial

plexus injury with Erb’s palsy and a developmental delay

Page 43