Obstetrics and Gynaecology Negligence Claims

Obstetrics is the branch of surgery that specialises in pregnancy and childbirth and gynaecology is the branch that specialises in disorders of the female reproductive system.  Doctors specialising in obstetrics are called obstetricians and those specialising in gynaecology are called gynaecologists, though the two areas overlap significantly and many doctors will practice in both areas.

Obstetrics

Obstetrics is the speciality involved with the management of pregnancy, including fertility medicine, delivery of the baby and management of the mother in the immediate period after childbirth.  Midwives will usually also be involved in the management of uncomplicated pregnancies and labour.  Obstetrics also includes the specialist field of reproductive endocrinology and infertility medicine, in which doctors aim to assist couples unable to conceive.

Obstetric negligence is one of the major causes of clinical negligence litigation.  The areas in which errors are made that are often the source of litigation include:

  • Management before pregnancy, including pre-conceptual counselling, infertility advice and treatment
  • Management during the pregnancy and before labour (antenatal), including:
  • The interpretation of scans looking for serious abnormalities in the unborn baby
  • The delay in diagnosis and management of an ectopic pregnancy
  • The failure to recognise and manage appropriately a high risk pregnancy, including pregnancy-induced hypertension (PIH)
  • Management during labour and delivery (intrapartum), including
  • The interpretation of the cardiotocograph trace (CTG) providing information about the baby's heart rate and the appreciation of the need to deliver urgently, especially by caesarean section if necessary
  • The choice of the method of delivery, including the use of forceps;
  • The technical performance of the delivery, which may result in avoidable damage to the mother and/or baby
  • Management immediately after delivery (postnatal), including
  • Appropriate management of the third stage of labour
  • Incorrectly sutured episiotomy

Errors in obstetric care can have a catastrophic outcome, with injuries being sustained by both the mother and the baby, including cerebral palsy, Erb's palsy (obstetric brachial plexus injury - OBPI), dislocation of the baby's hips, and even death of either or both of the mother and baby.

Wrongful birth cases are cases in which it is claimed that there has been clinical negligence in contraception, sterilisation or termination resulting in the birth of an unwanted baby who, but for the medical negligence, would not have been born.  There are broadly two types of wrongful birth case: the first is where there has been a failure in contraception or sterilisation/vasectomy resulting in the birth of an unwanted baby; the second is where parents have not been advised of the likelihood or presence of a disability in an unborn child, such that pregnancy would have either been prevented or terminated.

 

Gynaecology

Gynaecology is the speciality involved with the diagnosis, investigation and treatment of disorders of the female reproductive system, including: gynaecological oncology (the study of cancer of the female reproductive organs, e.g. cervical and ovarian cancer, including CIN (cervical intraepithelial neoplasia); gynaecological infections, including Chlamydia and pelvic inflammatory disease (PID); uterine disorders, including endometriosis and fibroids; ovarian disorders, including polycystic ovary syndrome; and genital prolapse.

Gynaecological clinical negligence claims can include: failed sterilisation; inappropriate technical performance of a surgical procedure, including insertion of a contraceptive coil, termination of pregnancy, hysterectomy, etc.; failure to diagnose and treat an infection; and delay in diagnosis of cancer.

 

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