news story about doctors performing C-section on woman who wasn't pregnant

[*MamaJen*]

The Fayettville Observer is reporting that doctors performed a C-section on a woman who showed up at the hospital claiming she was pregnant, but wasn't.
I'm having trouble believing this story. It says they tried to induce her three times -- wouldn't they have been monitoring fetal heart tones and noticed there was no heartbeat?

[kitkatkaddoodle]

If she hadn't had prenatal care and just showed up, yes, any OB who had half a brain would have done an u/s to see what was going on in there before doing ANYTHING to her, much less induce or take her to surgery.

I'm an L&D nurse, and if some doctor told me to try to induce a woman who wasn't getting heart tones and had no u/s to verify dates or anything, I'd refuse. The story is very fishy.

[AlexisT]

Yeah, this is straight up malpractice. They should have done an ultrasound.

[Fyrestorm]

There is something seriously missing from this story...

It says she showed up asking for a section...why would they try to induce at all?

If they tried to induce, why would they have her on pit without a monitor?

If they got no fetal tones, why wouldn't they have done a US? isn't that OB 101?

[rhiandmoi]

Well considering that the woman had pseudocyesis, and had proceded to "term" without that being discovered - she either had no prenatal care or demanded hands off prenatal care, and probably had a minimally trained provider such as a lay midwife with little experience (if she had been receiving ob care, I am sure that they would have also been listed in the complaint). With that, I see nothing extraordinary about her also refusing monitoring and ultrasound once walking in to the hospital. Without out those tools, doctors have basically their hands and eyes to figure out what the situation is. As has been stated many times on these boards, especially the UC boards, many things can look like pregnancy and make your body act pregnant. I am sure there is a lot more to this story, but if surgery progressed to the point where her uterus was out and they still thought she was pregnant - there was some kind of medical condition at work here causing the pregnancy symptoms.

[kitkatkaddoodle]

If she refused u/s and monitoring, the doctors STILL would have had to work out what was going on. What if she'd only been 30 weeks pregnant? What if she'd had a previa? There was absolutely nothing in that story that indicated the woman needed any kind of medical care other than demanding a c/s, which the doctors were not only well in their rights to refuse without more information, they SHOULD HAVE insisted on such a thing.

It is QUITE extraordinary for such a thing to occur. "I have a burst appendix and need surgery, but you aren't allowed to test me for anything, just take me to the OR right now!" Uh, no, you're getting evaluated. Same thing with pregnancy.

[rhiandmoi]

Upon taking her history and visual and I am assuming palpation exam she was diagnosed as pregnant and at term, the same way it used to be done in the good old days. The problem stems from this being an incorrect diagnosis. But if a resident OB has never had to diagnose pregnancy from visual and palpation alone, and there were other factors at play such as an enlarged uterus due to some other health problem or if the woman had a significant fat pad etc, it is understandable to see how a diagnostic mistake was made. Pseudocyesis used to get missed by experienced OBs and midwives all the time when it was a much more common issue.

Articles about pseudocyesis

http://www.nytimes.com/2006/12/05/health/05pseud.html
http://serendip.brynmawr.edu/exchange/node/70
http://www.enotalone.com/article/14808.html

http://www.falsepregnancy.net/

[kitkatkaddoodle]

I disagree that it was an understandable mistake, and even in the "old days" they had fetascopes. Also, there still seems to be no reason to induce a random woman who shows up claiming to be at term needing a c-section. An incorrect diagnosis of pregnancy is one thing, but to start such invasive treatment with little to no other information is ridiculous. Even if a woman showed up obviously pregnant with a kicking fetus to my L&D unit, there would be quite a lot of hesitation to induce her if she'd had no prenatal history at all, and we'd be double/triple cautious if the woman refused to let us evaluate her fetus--what if the baby was already in distress?

This story is just really, really strange, and this one article is the only thing I've been able to get any mention of such a thing happening in Fayetteville or anywhere.

[rhiandmoi]

http://abclocal.go.com/wtvd/story?se...cal&id=7361148

A little more info, but not much.

After reading/watching this, I am wondering if they were attempting a stillbirth delivery. It said there was an ultrasound done where no heartbeat was found (someone needs to go back to ultrasound school, because they should have seen that there was not only no heartbeat but no baby). But from the statement it's not clear who did the ultrasound, sounds like an intern, who convinced the resident, who convinced the supervising OB. Although, I would think that a stillbirth would have to be confirmed by a supervising doctor, and not just signed off on. A very strange case.

[kitkatkaddoodle]

Weird, weird, weird. Thanks for the link--I had been frustratingly unsuccessful in finding anything! I too would have thought someone other than the intern would have done an u/s to sign off a supposed fetal demise, and if the induction was taking days, another u/s to verify position of the fetus just to make sure there wasn't a positioning problem or something. A surgery to remove a stillbirth is usually a big deal, and avoided if possible.

The whole thing is just hugely odd. I wonder if the patient ended up getting mental health help.

[Kidzaplenty]

[Funny Face]

No matter how you play it or what info is missing this is just bizarre.

[AdinaL]

Very odd. But one of those things where everyone assumes that someone else has done the checks and due diligence, and they haven't. Still a weird story.

[Viola]

It actually doesn't seem that odd to me. It sounds like procedures weren't followed, and mistakes ensued. Probably someone didn't sign off on something that s/he was supposed to, and this happened. Disturbing stuff seems to happen in the hospital often enough to be frightening.