This is a continuation of my last blog post titled, “The Standard of Care when a Cesarean Section is Performed in the Delivery of an Infant ~ part 1.”
6.) Was it Recorded and Known when the Patient had her Prior Meal that was a Full Meal?
Why is this important? If the volume of the patient prior to aspiration is more than or equal to 30 ml, then this could predispose the patient to aspiration during the procedure.
7.) Was an Anesthesiologist Evaluation Performed on the Patient Before the C-Section Procedure?
Why is this important? It is very important that an anesthesiologist evaluate the patient prior to the procedure to determine which anesthesia should be given during the procedure such as a regional anesthetic or a general anesthetic.
8.) Were Baseline Laboratory Tests Performed by the Clinician?
Why is this important? Laboratory tests must be performed to determine the status of the patient such as the CBC (blood count that is complete), blood type, blood coagulation should be studied, and any cross match with blood as well as blood gas tests should be performed for the determination of the mother’s respiratory status.
9.) Was the need for a possible Blood Transfusion anticipated by the Clinician?
Why is this important? A pregnant woman may develop anemia. As such, a blood transfusion may be in order for this reason and also if there are other factors including, but not limited to, abnormalities with the placenta, eclampsia, if the woman has had more than one C-Section pregnancy deliveries, and the anesthesia itself.
10.) Were Antibiotics given to the Patient?
Why is this important? An intravenous, single dose of an antibiotic should be given so that the risk of a post-operative infection is reduced, and this should be given to all women who are undergoing a C-Section delivery.
11.) If the Patient was at a higher risk of a Thromboembolism, then did the Patient receive Anti-Coagulants?
Why is this important? If a woman that is having a C-Section is at a high risk of a thromboembolism, then prophylaxis (pharmacological and mechanical) should be given after hemorrhage issues are decreased, and said prophylaxis should be given within 6 to 12 hours after the operative procedure.
12.) Was the Heart Rate of the Fetus Documented and Monitored before the C-Section?
Why is this important? As we learned in my blog post about the fetus that was born with a severe and permanent brain injury, although the fetal monitoring strips were recording and showing that the fetus was in distress and that an emergency C-Section needed to be performed as soon as possible, the nurse and midwife did not contact the doctor for 30 minutes, and when the Dr. did arrive, he waited another 19 minutes to perform the emergency C-Section.
In that case, the nurse, midwife, and the respective employers of each were held liable for the permanent brain damage caused to the fetus due to this delay in contacting the Dr. The Dr., however, was not found to be liable under the circumstances.
The very important take away from that case and this question is that if there are signs on the fetal heart monitoring strip where any sort of fetal compromise that could be acute is detected, such as bradycardia and the like, then delivery of the fetus must happen as soon without delay as possible.
I will finalize my discussion of the Medical Standard of Care, or deviation thereof, in a C-Section Delivery of an Infant, in my next blog titled, “This is a continuation of my last blog post titled, “The baby boy blog sept 17Standard of Care when a Cesarean Section is Performed in the Delivery of an Infant ~ part 3.”
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These cases are very complicated and have very strict time limitations so we encourage you to contact us as soon as possible so that we may begin investigating your case.