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Case Example: Group B Strep
In this case, the mother was diagnosed GBS positive (Group B Strep) early in her pregnancy.
During her regularly scheduled prenatal visit at 38 weeks, she told the doctor during that visit that she did not feel well, had leg pain and that she had a sensation of the fetus balling up on her left side.
The doctor sent her for a Doppler to ultrasound her left leg but otherwise took no further action and told her that she had to wait for her scheduled cesarean section. The next day the patient woke with a fever of 101.2. She again contacted her doctor’s office and was told to take Tylenol, drink fluids and rest. The doctor told her to give her a call in the morning if anything was worse or if her temperature remained.
The following day, she was taken by ambulance to the hospital, where she was diagnosed with intrauterine fetal demise. Her baby was dead.
Here, the cause of the baby’s death was the bacterial infection of the placenta due to group B streptococcus. This could have been treated and the baby could have been saved. The doctor deviated from the standard of care by failing to bring the patient in for evaluation in light of her complaints of fever for consecutive days.
The standard of care requires that any pregnant woman complaining of a persistent fever to be evaluated to rule out illness that may harm the fetus. This is particularly true in a patient at 38 weeks gestation who is GBS positive and is complaining of a fever of 101. Had the patient been timely evaluated, she could have been given antibiotics, the fetus could have been monitored continuously to ensure fetal well-being and been delivered safely via a cesarean section.
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