Page 9 - OB Risks - Delivering the Goods (Part Two)

SVMIC Obstetrics Risks: Delivering the Goods

methotrexate. If a failure to diagnose or treat results in surgery

or a more complicated resolution to the ectopic pregnancy,
there may be higher exposure to liability.
14

In order to reduce the risk of errors, protocols to identify

and refer the PUL patient to specialized treatment should
be developed and utilized. Patients at high risk for ectopic

pregnancy or PUL may have risk factors, such as a history of
ectopic pregnancy, abdominal or pelvic surgery, pregnancy

following a sterilization failure, previous pelvic inflammatory
disease, or a history of infertility. Ectopic pregnancy risks
15
include rupture of the fallopian tubes, hemorrhage, and maternal
death. Likewise, surgery to resolve an ectopic pregnancy

may result in complications which may include hemorrhage,
infection, and death.
16

In order to avoid liability in regard to an ectopic pregnancy,
education of the patient and documentation are very important.

Potential liability involving an ectopic claim may be decreased
by the following:

• Make the diagnosis of ectopic pregnancy before giving

methotrexate.

• Carefully document previous pregnancy and delivery

history, including complications and outcomes.

• If the patient has risk factors for ectopic pregnancy, make

sure the patient’s treatment team is aware of the risk
factors, and that they are documented in the medical

record.

14 https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2018/11/early-
pregnancy-loss
15 https://emedicine.medscape.com/article/2041923-overview.
16 https://www.aimu.us/2017/06/25/ectopic-pregnancy-diagnosis-complications-and-
managment

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