Several factors have been associated with increased risk of maternal and fetal peripartum and postpartum infections, including pre-existing maternal conditions (e.g. malnutrition, diabetes, obesity, severe anaemia, bacterial vaginosis, and group B streptococcus infections) and unexpected or iatrogenic conditions during labour and childbirth, such as prolonged rupture of membranes (PROM) multiple vaginal examinations, manual removal of the placenta, and cesarean section. As such, the strategies to reduce maternal and fetal infections and their short- and long-term complications have been largely directed at preventive measures where such risk factors exist. In many cases of maternal and fetal infections, medical negligence may have played a role. In fact, a given infection may not have been detected during examinations, or proper treatment may not have been implemented in a timely fashion. In fact, some infections may become more severe if they are not properly treated as quickly as possible. The Authors have aimed to shed a light on the most common, and feared, childbirth-related infections, by means of a wide-ranging analysis of medical databases (Scopus, Pubmed, Embase, Research Gate, Web of Science), legal archives (Justia, Leagle, Lexis, Casetext) and recommendations issued by medical and scientific institutions (United Nations, World Health Organization, Centers for Disease Control and Prevention, National Health Service, etc…), spanning the 2004-2020 period. The inability on the part of physicians to thoroughly document the appropriateness of their interventions and the compliance with guidelines and best practices often results in claims being filed by damaged patients and/or their legal heirs. Litigation is typically complex in such cases, and likely to result in substantial compensatory damages being awarded to damaged patients. Currently, a higher standard for cautionary rules should be applied by practitioners and medical facilities to minimize the risk of claims being filed, particularly in tort courts. As a matter of fact, the current global setting of Covid-19 pandemic crisis has engendered unique conditions. Hence, specifically targeted measures are needed in maternity centers in order to stave off the contagion of healthy patients, while at the same time providing the best possible care for Covid-19 positive parturients and their newborns. Compliance with directives and regulations issued by health care authorities, aimed at the implementation of adequate diagnostic pathways, isolation protocols and protection requirements, is undoubtedly crucial for preventing malpractice allegations and liability.

Perinatal and post-partum infections in times of Coronavirus: are compliance with cautionary measures and safety protocols key factors in staving off litigation? / Marinelli, E.; Negro, F.; Varone, M. C.; Trojano, G.; Del Rio, A.; Zaami, S.. - In: ITALIAN JOURNAL OF GYNAECOLOGY & OBSTETRICS. - ISSN 2385-0868. - 32:3(2020), pp. 189-199. [10.36129/jog.32.03.05]

Perinatal and post-partum infections in times of Coronavirus: are compliance with cautionary measures and safety protocols key factors in staving off litigation?

Marinelli, E.;Negro, F.;Varone, M. C.;Del Rio, A.;Zaami, S.
2020

Abstract

Several factors have been associated with increased risk of maternal and fetal peripartum and postpartum infections, including pre-existing maternal conditions (e.g. malnutrition, diabetes, obesity, severe anaemia, bacterial vaginosis, and group B streptococcus infections) and unexpected or iatrogenic conditions during labour and childbirth, such as prolonged rupture of membranes (PROM) multiple vaginal examinations, manual removal of the placenta, and cesarean section. As such, the strategies to reduce maternal and fetal infections and their short- and long-term complications have been largely directed at preventive measures where such risk factors exist. In many cases of maternal and fetal infections, medical negligence may have played a role. In fact, a given infection may not have been detected during examinations, or proper treatment may not have been implemented in a timely fashion. In fact, some infections may become more severe if they are not properly treated as quickly as possible. The Authors have aimed to shed a light on the most common, and feared, childbirth-related infections, by means of a wide-ranging analysis of medical databases (Scopus, Pubmed, Embase, Research Gate, Web of Science), legal archives (Justia, Leagle, Lexis, Casetext) and recommendations issued by medical and scientific institutions (United Nations, World Health Organization, Centers for Disease Control and Prevention, National Health Service, etc…), spanning the 2004-2020 period. The inability on the part of physicians to thoroughly document the appropriateness of their interventions and the compliance with guidelines and best practices often results in claims being filed by damaged patients and/or their legal heirs. Litigation is typically complex in such cases, and likely to result in substantial compensatory damages being awarded to damaged patients. Currently, a higher standard for cautionary rules should be applied by practitioners and medical facilities to minimize the risk of claims being filed, particularly in tort courts. As a matter of fact, the current global setting of Covid-19 pandemic crisis has engendered unique conditions. Hence, specifically targeted measures are needed in maternity centers in order to stave off the contagion of healthy patients, while at the same time providing the best possible care for Covid-19 positive parturients and their newborns. Compliance with directives and regulations issued by health care authorities, aimed at the implementation of adequate diagnostic pathways, isolation protocols and protection requirements, is undoubtedly crucial for preventing malpractice allegations and liability.
2020
childbirth infections; claims; covid-19; safety protocols; sanitation practices
01 Pubblicazione su rivista::01a Articolo in rivista
Perinatal and post-partum infections in times of Coronavirus: are compliance with cautionary measures and safety protocols key factors in staving off litigation? / Marinelli, E.; Negro, F.; Varone, M. C.; Trojano, G.; Del Rio, A.; Zaami, S.. - In: ITALIAN JOURNAL OF GYNAECOLOGY & OBSTETRICS. - ISSN 2385-0868. - 32:3(2020), pp. 189-199. [10.36129/jog.32.03.05]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1454502
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