Problems...Wait...What Problems?

By Gerard Pregenzer, MD

An actual letter from an OB Chairman:

Dear Colleagues:

Our neonatologists are concerned that fetal abnormalities found on prenatal ultrasounds are not being transmitted to them.

In many cases they are not even mentioned in the patients chart.

Two recent “near misses” have highlighted the problem- one involving a suspected cardiac anomaly, the other hydronephrosis. In NEITHER case did the relevant information appear in the patients chart, nor were the neonatologists informed by the delivering OB or L&D staff. In both cases one of the parents informed them of the abnormal prenatal findings (albeit quite inaccurately), shortly before discharge from the Nursery. Baby #1 required emergency surgery for critical coarctation of the aorta; baby #2 underwent emergency surgery for an obstructing ureterocoele. These are the ones they know about.

Please be sure that abnormal finding that may affect the immediate post-partum care of the infant are adequately documented in the chart or, at least, communicated verbally to the neonatal group.

Thank you,

Chairman, Department of Obstetrics & Gynecology

Both doctors’ electronic medical records had nothing about those babies having a known birth defect that needed attention right after birth. Thank goodness, for each instance, the pediatricians were able to determine a problem existed and, then, to identify the exact problem and quickly attend to it.  But, why take a chance?