A woman in her early 40’s who became pregnant through in vitro fertilization suffered fetal demise after developing acute fatty liver syndrome, causing her to claim her doctors had been negligent in their care. Initially, the patient had become pregnant after multiple rounds of IVF, and was noted by her doctors to have a history of borderline hyperthyroid which could potentially induce nausea or weight loss. She was evaluated to not be a high-risk pregnancy, and was scheduled to have regular checkups with her doctors. At 36 weeks, however, she was admitted to Emergency Services after repeatedly calling her doctor with complaints of acid reflux, nausea, a bloody nose, lethargy, confusion, and distinctively yellow-toned skin. Though her doctor’s office had allegedly told her not to worry about her reflux, nausea, or bloody nose, the emergency services evaluation noted that her alkaline phosphatase levels were triple the expected amount and that no fetal heartbeat could be found. She was diagnosed with acute fatty liver syndrome as the cause of fetal demise, and the following trial used testimony from medical specialists to assess the case.
Question(s) For Expert Witness
- 1. What kind of measures should be taken if a pregnant patient calls her physician multiple times with several complaints?
- 2. Should a patient who became pregnant after 5 rounds of IVF be considered high risk?
Expert Witness Response E-007850
I am a Maternal Fetal Medicine specialist and I have taught Residents for over 20 years. If a pregnant patient calls her physician multiple times with several complaints, she should be seen in the office or at the hospital. The patient should have been monitored closely, though a patient being pregnant in her early 40’s is more high-risk than a patient who has become pregnant after multiple rounds of IVF.