Ob opts for monitoring instead of cerclage
<court>Undisclosed County (Mass)</court>
A woman at 10 weeks’ gestation presented to an obstetrician in June; her history was significant for diethylstilbestrol exposure, laser conization of the cervix due to noninvasive cervical cancer, a cerclage placed at pregnancy 7 years earlier, and several years of in vitro fertility treatments leading to this conception.
Though her prior obstetrician—now retired—had anticipated a need for cervical cerclage with any future pregnancies, her current doctor opted for frequent monitoring via ultrasound in lieu of cerclage.
Sonograms at 14 and 18 weeks revealed a normal cervix. An ultrasound in late August, however, showed the cervix 1 cm dilated with membranes bulging into the vagina; an emergency cerclage was ordered. The woman was released home and ordered to bed rest.
The woman’s membranes ruptured at 25 weeks’ gestation. At 26 weeks, 3 days, contractions began; the child was delivered via cesarean section. He now suffers from spastic diplegia.
The plaintiff noted that the child’s injuries stemmed from his premature birth.
The Ob/Gyn maintained that the mother’s history did not warrant cerclage placement, and argued that regular monitoring was an appropriate course of action.
- The case settled for $1.4 million.
The cases in this column are selected by the editors of OBG Management from Medical Malpractice Verdicts, Settlements & Experts, with permission of the editor, Lewis Laska, of Nashville, Tenn (www.verdictslaska.com). While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.