An unusual traumatic delivery malpractice: a case report
Azadeh Memarian1, Seyed Hossein Moosavinezhad Baboli1, Nahid Dadashzadeh Asl1
1Department of Forensic Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
The Medico-Legal Journal
|November 23, 2018
Summary
Severe birth trauma occurred in a 26-week premature infant due to forceful delivery complications. This case highlights the critical need for accountability in medical negligence during childbirth.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Trauma
- Medical Malpractice
Background:
- Birth trauma can result from mechanical forces during delivery.
- Premature rupture of membranes (PROM) and maternal fever are risk factors for adverse neonatal outcomes.
Observation:
- A 39-year-old primigravida at 26 weeks gestation presented with PROM and fever.
- Despite early antibiotics, a deceased fetus with a footling presentation was delivered via forceful traction.
- Fetal head entrapment occurred due to disproportionate fetal size and maternal pelvic dimensions, leading to cervical fracture and decapitation.
Findings:
- The delivery team's excessive traction on the fetus resulted in a fractured neck and decapitation.
- A cesarean section was required to retrieve the fetal head, a week after PROM.
- The hospital and staff faced a lawsuit for the fatal birth injury.
Implications:
- This case underscores the importance of appropriate management of PROM and careful delivery techniques in high-risk pregnancies.
- It emphasizes the need for accountability of healthcare professionals in cases of medical negligence leading to birth injuries.
- Ensuring adherence to obstetric protocols is crucial to prevent catastrophic outcomes like fetal decapitation.
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