Preeclampsia is a disorder in pregnant women which is marked by sudden increases in blood pressure both during pregnancy and during the weeks following delivery. Occurring in about five to eight percent of pregnancies in the United States, preeclampsia can be life-threatening to mother and baby if not promptly detected and appropriately treated. Untreated preeclampsia may cause, among other health issues, seizure, stroke, and multiple organ failure.
With a disorder that occurs in at least one out of twenty pregnancies and can have such devastating consequences, one would expect that doctors would diligently screen for preeclampsia, and most are alert to the signs and symptoms. These include, in addition to blood pressure that exceeds 140/90, protein in the pregnant woman's urine, swelling of hands, feet, and limbs, sudden weight gain, headaches and blurry vision. However, there is no definitive test for preeclampsia, and some women report few symptoms. This can make detection challenging.
That does not mean, though, that there are not things that obstetricians can and should do in order to detect preeclampsia. Failure to diagnose preeclampsia in some cases may constitute medical malpractice.
Of course doctors should always be alert to the possibility of preeclampsia, but there are certain risk factors that should make them take particular note that a woman's symptoms may be linked to preeclampsia. Women who are under 18 or over 40, obese, pregnant for the first time, pregnant with multiples, or who have a personal or family history of preeclampsia are at higher risk of the disorder. Many women who develop preeclampsia have no history or known risk factors, however, so doctors should not ignore their symptoms.
The onset of preeclampsia tends to occur around or after the 20th week of pregnancy, so doctors should be asking about symptoms at this time. While high blood pressure and protein in urine are hallmarks of the disorder, OB/GYNs should be considering a constellation of factors that might point them in the right diagnostic direction.
While there is no single test for preeclampsia, certain measures can make detection easier. These include more frequent prenatal visits and blood pressure monitoring. Once a diagnosis has been made, doctors should develop a plan for management of the disorder and communicate the importance of management to their patients. The prefix "pre" in the name may suggest that an illness is in the early stages of development, but is not really serious. We know that this is not the case with preeclampsia.
Treatment plans may include bed rest, hospital visits for care, multiple daily blood pressure checks, and blood pressure medications. Under some circumstances, the mother is best served by remaining in the hospital for care until the baby's delivery, so that more frequent blood pressure and urine checks can be performed, and so that a magnesium sulfate ("mag") drip can be administered. This may help prevent the development of eclampsia.
Hospital-based care also makes it easier to determine whether, for the health of the baby or mother, it would be wise to induce labor or perform an emergency caesarian section.
Misdiagnosis of preeclampsia rises to the level of medical malpractice if the physician did not take the actions that a similarly-situated physician would reasonably take in the same circumstances. If preeclampsia was diagnosed, but the doctor failed to take the appropriate treatment measures to preserve the health of mother and baby, and harm resulted, malpractice has also occurred.
However, not every case of preeclampsia, eclampsia, or HELLP Syndrome is the result of negligence on a doctor's part. How can you know if your doctor acted negligently? If you have suspicions that he or she committed malpractice, the best thing to do is to consult with an experienced medical malpractice attorney who can help you decide whether you have a cause of action worth pursuing. If the attorney believes you do, filing a malpractice case can not only get you the financial help to which you're entitled, but can prevent a negligent doctor from harming another family. An ethical medical malpractice attorney will not push you to pursue a case that doesn't appear to have a reasonable chance of success and will explain the challenges of the case so that you can make an informed decision about how to proceed.
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