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

SVMIC Obstetrics Risks: Delivering the Goods

subsequently performed which identified placenta previa,

and this was also noted in the patient’s office record.
Another ultrasound was performed in February during the

32nd week of the pregnancy and found that the patient
had developed oligohydramnios as well as the placenta

previa.

Twice-weekly stress tests were performed until March 1st,
which were all reassuring. On March 1st, the ultrasound

in her treating obstetrician’s office showed an amniotic
fluid index of 2.6 warranting the immediate delivery of

the infant. The treating obstetrician determined that an
emergency C-section should be performed, but due to

another emergency, was unable to provide continuous
care to the patient and sent her to the hospital.

She was admitted to the hospital labor and delivery
unit with routine admission orders for cesarean section,

including type and screen for three units of blood.
When the anesthesiologist asked why the patient was

having a C-section, the staff thought it was because of
the oligohydramnios, coupled with her history of prior

C-sections. The surgical team, which did not include the
patient’s regular OB, was not informed of the patient’s

placenta previa, and because of the urgent nature of the
delivery, the prenatal records with this information were

not sent to the hospital.

The anesthesiologist started the case and then turned it
over to a certified registered nurse anesthetist (CRNA).

An epidural was inserted, and the on-call obstetrician
accessed the uterus through a previous C-section

incision, where bleeding and an adherent bladder were

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