This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (17)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in JAMA  Topic Collections  • Surgery  • Surgical Interventions  • Urology  • Women's Health  • Pregnancy and Breast Feeding  • Alert me on articles by topic  Social Bookmarking   What's this?

Benjamin P. Sachs, MB, BS, Discussant

JAMA. 2005;294:833-840.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR DELBANCO: Mrs W is a married, self-employed, healthy woman living in a community several hours from Boston. She has private health insurance. At age 38, she was admitted to the hospital for elective delivery of her first child, but the admission ended tragically with fetal loss, hysterectomy, and a prolonged hospitalization.

The pregnancy, her first, was wanted and uneventful. When seen initially by her obstetrician, Mrs W’s blood pressure was 112/80 mm Hg. She showed no sign of labor at term. At 40 weeks of pregnancy, her blood pressure was 126/78 mm Hg, rising shortly thereafter to 144/85 mm Hg. She had trace proteinuria. Her creatinine level was 0.8 mg/dL (70.7 µmol/L), and her uric acid level was 6.3 mg/dL. At 41 weeks of gestation, her obstetrician, Dr F, decided to admit her for misoprostol induction. Dr F . . . [Full Text of this Article]

THE PATIENT AND HER HUSBAND: THEIR VIEWS

THE PRIMARY OBSTETRICIAN: HER VIEW

AT THE CROSSROADS: QUESTIONS FOR DR SACHS

Diagnosis and Risk Factors

The Outcome

What Went Wrong?

Patient Safety and Long Shifts

Improving Quality of Care

Responding to Mrs W’s Tragedy

Evaluating Systems Changes

QUESTIONS AND DISCUSSION

AUTHOR INFORMATION

Author Affiliation: Dr Sachs is Chief, Obstetrics and Gynecology, Beth Israel Deaconess Medical Center; Harold H. Rosenfield Professor of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; and Professor in the Department of Society, Human Development and Health in the Faculty of Public Health, Harvard School of Public Health, Boston, Mass.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED LETTERS

A Woman With Fetal Loss
Charles L. Blander
JAMA. 2006;295(4):386.
EXTRACT | FULL TEXT  

A Woman With Fetal Loss
Mandy Sander-Prather and Martin De Ruyter
JAMA. 2006;295(4):386.
EXTRACT | FULL TEXT  

A Woman With Fetal Loss—Reply
Benjamin P. Sachs
JAMA. 2006;295(4):386-387.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Multiprofessional 'fire-drill' training in the labour ward
Siassakos et al.
The Obstetrician and Gynaecologist 2009;11:55-60.
ABSTRACT | FULL TEXT  

Between a Rock and a Hard Place: Disclosing Medical Errors
Crone et al.
Clin. Chem. 2006;52:1809-1814.
ABSTRACT | FULL TEXT  

A cross-cultural survey of residents' perceived barriers in questioning/challenging authority.
Kobayashi et al.
Qual Saf Health Care 2006;15:277-283.
ABSTRACT | FULL TEXT  

Clinical Crossroads: Expanding the Horizons.
Winker
JAMA 2006;295:2888-2888.
FULL TEXT  

A Woman With Fetal Loss
Blander
JAMA 2006;295:386-386.
FULL TEXT  

A Woman With Fetal Loss
Sander-Prather and De Ruyter
JAMA 2006;295:386-386.
FULL TEXT  

Beyond Disclosure: Seeking Forgiveness
Purtilo
ptjournal 2005;85:1124-1126.
FULL TEXT  

Medical Errors
Holder
ASH Education Book 2005;2005:503-506.
ABSTRACT | FULL TEXT