What a obstetrics review usually focuses on

Pregnancy, labor, fetal monitoring, and delivery. A case review should reconstruct the sequence of prenatal risk, fetal monitoring, labor progression, delivery decisions, and maternal and newborn condition from the records available at each decision point.

Five decision points to map

  • 1. Prenatal risk
  • 2. Fetal monitoring
  • 3. Labor progression
  • 4. Delivery decisions
  • 5. Maternal and newborn condition

Records that can answer those questions

  • Obstetrics consultation, procedure, or encounter notes
  • Orders and test results used to make the clinical decision
  • Medication, monitoring, procedure, or nursing records tied to the event
  • Communication with the patient and other specialties
  • Later treatment showing the complication, corrected diagnosis, or outcome

Expert and causation questions

  • What training and specialty should the reviewing obstetrics expert have under state law?
  • Which of the key decision points in pregnancy, labor, fetal monitoring, and delivery is actually being challenged?
  • What information was available at that time, not only in hindsight?
  • What part of the later harm is attributable to the underlying illness or known risk?
  • Would a different medical decision probably have changed treatment or outcome?

Related specialties

Use licensing, records, and medical-information sources appropriate to the specialty.