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Medico-legal considerations and operative vaginal delivery
ملاحظات پزشکی قانونی و زایمان واژینال عملیاتی-2019 Women undergo operative vaginal delivery (OVD) as an alternative
to caesarean section when complications arise in the
second stage of labour. The perinatal mortality associated with
OVD is very low, and most of the perinatal morbidity is minor.
However, when serious adverse events occur, such as traumatic
birth injury, shoulder dystocia, cerebral palsy and perinatal
death, there are medico-legal implications. There is also the
potential for litigation in relation to maternal pelvic floor injury,
which is increased with OVD. Obstetricians performing and supervising
OVDs need to be aware of the potential pitfalls and
minimise the risk of adverse outcomes. Given that most obstetricians
will be involved in adverse birth-related events, it is
important that they are aware of the legal processes that may
ensue. It is also important when reviewing adverse OVD-related
outcomes that association is differentiated from causation. These
issues are addressed in the current chapter with attention drawn
to the Montgomery ruling, which redefines the legal standards
expected in relation to informed consent. Keywords: Operative vaginal delivery (OVD) | Serious adverse events | Litigation | Medico-legal | Causation | Montgomery ruling |
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