Child Sustains Cognitive Damage During Urgent Delivery

This case involves a young mother who went into induced labor after experiencing a number of complications with her pregnancy. During labor, the patient began to appear discolored, and testing revealed progressive signs of fetal distress. The decision was made to proceed to urgent delivery via vacuum extraction. During the extraction additional complications, including shoulder dystocia, were encountered, and the mother suffered a uterine rupture. The infant suffered a number of injuries during her delivery, and was eventually diagnosed with cerebral palsy. It was alleged that doctors should have opted for a cesarean section instead of a vacuum extraction, which would have avoided injuries to both mother and her daughter.

Question(s) For Expert Witness

1. What is the proper protocol when observing progressing signs of fetal distress while inducing labor?

2. What steps could have reduced this patient's risk for uterine rupture? Please explain.

3. Do you frequently treat patients similar to the patient describe in this case?

Expert Witness Response E-009197

As the a professor of obstetrics and gynecology and as the residency director at a university affiliated medical center, I frequently treat patients similar to the patient described in this case. This case is right in my area of expertise. My concern is that there could have been greater continual monitoring which is the proper protocol when observing progressing signs of fetal distress. In a case like this, one wants to continually monitory as to so not miss any fetal patterns, check in that the fetal heart rate is reassuring, mitigate all risks, and properly time a c-section.