Pregnant Lady Refusing Caesarean section - USMLE Forums
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  #1  
Old 07-16-2011
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Medicolegal and Ethics Pregnant Lady Refusing Caesarean section

A 32 yrs old Caucasian mother is admitted to the labor unit with complaints of intense abdominal pain, heavy vaginal bleeding and uterine contractions every seven minutes. She is thirty weeks gestation and has missed most of her prenatal care appointments. Fetal heart rate monitoring indicates the fetus is in distress and ultrasound confirms placental abruption. The patient is informed of an urgent need of caesarean section. She refuses and insists on vaginal delivery. Which is the next appropriate step
1) proceed with caesarean section because there is evidence of fetal distress
2) proceed with caesarean section because the mother is endangering a viable fetus with her request
3) inform the patient she is being unreasonable
4) transfer the patient to another obstetrician
5) allow her to proceed with normal vaginal delivery
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  #2  
Old 07-17-2011
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3? isn't 1 and 2 pretty much the same thing, endangering the fetus
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  #3  
Old 07-17-2011
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i would go for B...isn't it related to trimester's and age of viability....
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  #4  
Old 07-17-2011
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Wink try again

both b and c are wrong answers.try again!!
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  #5  
Old 07-17-2011
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than it has to be 5.??
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Old 07-17-2011
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A, because you have to do best standard for the fetus?
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  #7  
Old 07-17-2011
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Default 5th one

i would go with 5 th answer bcuz 1,2 are kinda same,3 rd wont change anything,4 th kinda of stupid, so we have left with 5 th one ...
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  #8  
Old 07-17-2011
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Default how do i check my answer?

i choose answer 5 because the lady has the right to decide until the child is born(then the medical law decide how to handle the child distress without the woman consent)?
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  #9  
Old 07-17-2011
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Smile the pregnant lady gets to decide!!!!

the correct answer is indeed 5
the explanation given is as follows:
although this pt wishes are not in the best interest of her unborn child,she is entitled to make decisions that affect the fetus while it remains attched to herbeco it is still considered a part of her body.therefore she cannot be forced to accept a treatment even though it means her unbornchildmay not survive as a result
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  #10  
Old 07-17-2011
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proceed with vaginal delivery i think
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  #11  
Old 07-17-2011
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5)Allow her proceed to normal delivery.
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  #12  
Old 07-17-2011
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what would you do if she was acutely psychotic?
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