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Audible pop at delivery signals diastasis.

A 36-year-old woman pregnant with her first child was admitted to the hospital in labor. The next morning she was completely dilated and effaced. She started pushing and, after 2 hours, forceps were used. An audible popping sound occurred at delivery and was noted in the records as a possible fracture of the coccyx. The patient, in great pain after the delivery, had suffered a 3-cm pubic symphysis diastasis (PSD) as shown on a pelvic CT scan. She was discharged after 6 days, and home treatment was arranged. The PSD healed before the trial.

Patient's claim Inadequate fetal descent during the second stage of labor should have prompted a cesarean section. Cephalopelvic disproportion was present, and excessive force was used during the forceps delivery.

Doctor's defense There was no cephalopelvic disproportion, and excessive force was not used. Also, PSD is a known risk factor of pregnancy.

Verdict Defense verdict.

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Title Annotation:MEDICAL VERDICTS: NOTABLE JUDGMENTS AND SETTLEMENTS IN BRIEF
Publication:OBG Management
Article Type:Brief article
Date:Apr 1, 2007
Words:149
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