Page 30 - OB Risks - Delivering the Goods (Part One)

SVMIC Obstetrics Risks: Delivering the Goods

C A S E S T U DY

In one case, the baby’s shoulder dystocia resulted in Erb’s

Palsy. Upon review of the baby’s delivery, the physician
noted that when he discussed the risk of a vaginal delivery

with the patient, the possibility of a shoulder dystocia was
not clearly explained during that discussion. This became

an issue for the defense team because the mother was a
gestational diabetic who was to be induced at 38 weeks

due to a history of miscarriages. Both the possibility of a
larger infant, as well as the use of tocolytic, increased the

risk of a shoulder dystocia for this infant and should have
been outlined in detail for this mother during the consent

discussion.

Consider the next case where informed consent was lacking:

C A S E S T U DY

A mother who had a cesarean section one year prior was
not informed of the risk of a uterine rupture during labor.

The mother presented to labor and delivery with
complaints of labor pains and decreased fetal movement.

She was admitted and monitored by the L & D staff. The
staff was informed by the physician that he would allow

the patient to undergo a trial of labor after cesarean
(TOLAC) per the mother’s request. Because he was not

in the hospital at the time, he did not have a consent
discussion with the mother about this request. The patient

missed her previous two office appointments, so a prior
informed consent discussion never occurred. As labor

progressed and the pain became more significant, the

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