Case Study- Fetal demise

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Case Study: Stillbirth risk factors lead to fetal demise
Background:
T.T. (primigravida, 39weeks) was admitted to XX Hospital on xx/20/xxxx with complaints of
spontaneous ruptures of membranes. Ultrasound technicians noted no fetal heart tones, but the
patient’s family insisted that the baby continued to move and kick. A Caesarean section was
performed on the same day. A full term, fetal demise female child with Apgar 0, 0 was delivered via
a total breech extraction.
Action:
Trivent’s gynecologist organized a medical chronology and medical opinion by reviewing T.T.’s
medical records, focusing on why there was a delay in planning the C-section. Our physicians noted
that there was a deviation from the standard of care that led to fetal demise. Since the patient had
multiple risk factors that could have contributed to a stillbirth, intervention should have occurred
earlier.
Conclusion:
The most common risk factors associated with stillbirth are: non-Hispanic black race, nulli-parity
(no previous births), advanced maternal age, and obesity. Hypertension and diabetes, both risk
factors for stillbirth, are two of the most common medical conditions that occur along with
pregnancy.
Failure to do a timely intervention was a deviation in the standard of care, as this could have
prevented the fetal demise. Failure to attempt vaginal delivery after the fetal demise was also a
deviation in the standard of care.
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