When a pregnant patient visits their physician with symptoms and complaints that point to a possible vaginal infection, a physician’s first step should be a comprehensive evaluation to accurately diagnose the cause of the symptoms. This evaluation involves reviewing the patient’s clinical history, performing a physical exam, and ordering diagnostic testing to tell apart the common causes of infection.
A physician should then tailor treatment to the diagnosis, with an emphasis on pregnancy-safe medications. The patient should receive guidance and follow up care as need to protect both the mother and baby.
Acute chorioamnionitis is a serious bacterial infection and acute inflammation of the placental membranes and amniotic fluid surrounding a fetus during pregnancy. This infection is typically caused by a bacterial infection that travels up from the vagina, cervix, or rectum, to the cervical canal and into the amniotic sac.
This type of infection can cause complications for both mother and baby. Fetal and neonatal complications can include fetal tachycardia, fetal inflammatory response syndrome, neonatal sepsis and pneumonia, and other long-term developmental risks.
In this case, however, our client lost her child to stillbirth due to acute chorioamnionitis that developed after a diagnosed vaginal infection went untreated. The Townsley Law Firm represented her and recovered a settlement of over $200,000.
Following Through on a Documented Treatment Plan Is Basic to Safe Prenatal Care
Our client was pregnant with her first baby. Early in her pregnancy, she told her obstetrician she was experiencing heavy vaginal discharge and pelvic pain. A vaginal culture was collected, and the results showed an overgrowth of several infectious organisms. Because she was about ten weeks pregnant at the time, she needed a prescription for Flagyl, an antibiotic, to treat these organisms in her second trimester.
Her obstetrician wrote the need for this future antibiotic treatment directly into her medical record. Our client was unaware of that plan. Neither the obstetrician nor her office staff made sure the medication was ever prescribed. When our client returned for a visit in her second trimester, nothing in her chart showed that Flagyl had been prescribed, and the treatment note made no mention of any follow-up on her earlier abnormal lab results.
A physician who diagnoses an infection and documents a treatment plan has to carry that plan out. A note in the chart does not protect a patient or her baby. The prescription does. Here, the infection was known, the treatment was identified, and the order was simply never completed.
Passing Along Records Is How Care Continues Safely When a Patient Changes Providers
Unhappy with her care, our client switched to a new obstetrician during her pregnancy. She had no idea she still needed antibiotic therapy in her second trimester. Her original obstetrician and staff then failed to provide her new provider with a proper history and records about the infection and the treatment it required.
When a pregnant patient transfers to a new provider, her history does not travel with her automatically. The provider who diagnosed the infection holds the information the next provider needs to continue treatment safely. Sharing that information is a basic part of continuity of care, not an optional courtesy.
This breakdown in communication meant the one piece of information that could have led to treatment never reached the new provider. A gap in information became a gap in care. Our client and her baby bore the consequences.
How an Untreated Infection Led to Acute Chorioamnionitis
Acute chorioamnionitis can develop when a vaginal infection goes untreated during pregnancy. It is a serious condition that threatens both mother and baby, and it is one reason infections during pregnancy are treated promptly with antibiotics. When the underlying infection is not treated, it can travel upward and reach the environment the baby depends on.
Our client went into labor prematurely. She came to a hospital emergency room with abdominal pain and pressure, and within thirty minutes of arriving, she delivered a stillborn baby boy. Both the baby and the placenta were noted to be foul-smelling. She was diagnosed with acute chorioamnionitis, and pathology found the placental fetal membranes to be thick, yellow-green, and opaque, all signs of infection. Lab results confirmed an acute intrauterine infection that led to the stillbirth.
The path from a treatable vaginal infection to this outcome ran through preventable failures. The antibiotic her obstetrician knew she needed was never prescribed, and the records that would have alerted her new provider were never passed along. Our client suffered unnecessary pain, anxiety, and loss of enjoyment of life, and her baby was denied the chance of a better outcome. The infection did not have to reach this point. The care that would have stopped it was not provided.
