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Medical Verdicts

Ob opts for monitoring instead of cerclage

November 2004 · Vol. 16, No. 11

<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 ( While there are instances when the available information is incomplete, these cases represent the types of clinical situations that typically result in litigation.

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