Legal Briefs: Velamentous Cord Insertion Results in Blood Loss and Adverse Outcome

A 1,950-g, 34-week-gestation, second twin was delivered to a 34-year-old gravida 8, para 3 woman whose pregnancy was remarkable for dichorionic, diamniotic twinning and a velamentous insertion of the umbilical cord, detected on fetal ultrasonography 4 months before delivery. The mother was admitted for preterm labor at 32 weeks’ gestation. During the 2-week hospitalization, the mother received magnesium sulfate for tocolysis and antenatal steroids. Her fetus’ heart rate was intermittently monitored; many variable and late decelerations were apparent. The obstetrician retained by the plaintiff was critical of the mother not being continuously monitored and was critical of the caregivers for not doing a thorough evaluation of the status of the twins in the face of the decelerations. The umbilical cord was vulnerable to contractions because it was velamentously inserted. The plaintiff obstetrician found fault with the treating obstetrician for being unaware of the velamentous cord detected prenatally. When labor ensued,...