Obstetrics Complications are on the Rise

pregnant lady in a garden

An obstetrician’s job is to manage pregnancy from the time a woman is first seen in the physician’s clinic until the six week postpartum visit.  There are many things that can cause a problem during pregnancy and management of these issues is the responsibility of the obstetrician to ensure that a healthy baby is born.  Failure by an obstetrician too follow established protocols may be classed as negligence and result in legal action for compensation by medical malpractice lawyers.

Miscarriage

In early pregnancy, the obstetrician needs to be aware of the possibility of prior miscarriages, says https://www.lawmedmal.ca/.  If this is the case, there are tests that can be done and interventions that can made to reduce the risk of subsequent miscarriage.  Failure to deal with these issues may be medical malpractice dependent on the circumstances.

Testing

There are testing procedures that are usually offered during pregnancy.  Ultrasound scans are recommended to be carried out during all pregnancies to look for problems including placenta previa, fetal abnormalities and spina bifida/anencephaly.  Mothers should also be offered chorionic villus sampling or amniocentesis both of which test for genetic disorders including Down syndrome, cystic fibrosis, or spina bifida.

Genetic Disorder Testing

If a genetic disorder is discovered, the woman can have an elective abortion or at least has time to get used to the fact that their child has a genetic problem before delivery.  These tests are important.  The ultrasound carries no risk, but the other tests can result in spontaneous miscarriages and this must be conveyed to the mother before the test.   

Gestational Diabetes

Obstetricians should offer a pregnant woman a screening test for gestational diabetes.  It is usually carried out around 24 weeks gestation and is a test that identifies those pregnant women whose blood sugar is too high.  A woman with gestational diabetes must be carefully managed with ultrasounds, nonstress tests and dietary management to keep the blood sugar low.  If the doctor fails to offer this test, there can be unwanted life-threatening complications which is a medical malpractice situation.

Preeclampsia

Obstetricians must be careful to watch for high blood pressure during pregnancy. This issue needs to be managed with bed rest, regular visits to the doctor, and ultrasound examination to test fetal health.  If high blood pressure is associated with swelling of the woman’s body and protein in the urine sample, then it is called preeclampsia.  The physician may need to use medications to control high blood pressure and may decide there is a need for earlier than expected delivery if there is evidence of fetal distress.  Failure to adequately treat pre-eclampsia leads to a condition called eclampsia which usually means that the baby needs to be delivered imminently.

Preterm Birth

Preterm birth can cause serious complications including cerebral palsy, cerebral hemorrhages, and gastrointestinal problems in the infant.  The doctor must pay attention to the mother’s description of contractions early in pregnancy and must check the maternal cervix to see if the cervix is opening or thinning out prematurely—a sign of possible preterm labor.  If the doctor does not do these things and the contractions turn into preterm labor that cannot be stopped, then the baby is considered preterm and may have serious or fatal complications.

Delivery

In a normal pregnancy, the doctor is responsible for managing the delivery of the infant. This means estimating the fetal size and the fetus/pelvic bone structure proportions to make sure the delivery will actually happen.  The fetus, nowadays, is monitored throughout the delivery process to check for evidence of fetal distress that might mean an imminent or emergency cesarean section should be scheduled.  The obstetrician is responsible for the safe delivery of the child.  This means avoiding shoulder dystocia (stuck shoulders) and avoiding pulling too hard on the baby’s neck and shoulders, which can result in damage to nerves in that area. Erb’s palsy or paralysis of the arm may be caused by the doctor being overzealous in putting traction on the fetal shoulders and neck Which may be classed as medical malpractice.

Postpartum Hemorrhage

With a normal delivery, there can also be postpartum hemorrhages that threaten the life of the mother after delivery.  If a postpartum hemorrhage occurs, the doctor may need to clean out the uterus in the operating room to stop bleeding.  In extreme cases, an emergency hysterectomy may need to be performed to save the life of the mother.

Postpartum Infections

Postpartum infections are a possibility, even in pregnancies that have been normal up until then.  The mother experiences increased pain, fever and bleeding that can occur in the first few days following the delivery.  It is the responsibility of the obstetrician to recognize when this has happened and to treat the mother with antibiotics to fight off the infection.  An untreated infection of this nature can potentially lead to sepsis and shock and death.

Postpartum Visit

At the six week postpartum visit, the obstetrician assures that the patient’s uterus has returned to normal and offers the mother the option of birth control methods to prevent a pregnancy in the near future.