Research on the Causes and Risk Control of Adverse Outcomes in Maternal Delivery Based on Medical Malpractice Appraisal

LIN Mingjiao; LIN Mingjuan

doi:10.16458/j.cnki.1007-0893.2025.24.005

Abstract：Objective To analyze the causes and risk prevention of adverse delivery outcomes in pregnant women in medical malpractice cases,and to provide theoretical support and practical guidance for clinical perinatal risk prevention and maternal and infant safety assurance.Methods Retrospective analysis was conducted on 46 cases of medical malpractice cases involving adverse delivery outcomes in pregnant women and where medical negligence was determined,which were received by Guangdong Zhongyi Forensic Science Center from January 2019 to December 2024.The overall distribution of medical negligence was clarified,and the correlation between hospital grades and main types of negligence was analyzed.Based on the analysis results,risk prevention measures for adverse delivery outcomes after delivery were proposed.Results From the distribution of medical negligence by hospital grades,13 cases(28.3%)involved secondary hospitals and 33 cases(71.7%)involved tertiary hospitals;from the distribution of medical negligence by process,medical negligence mainly occurred in prenatal assessment and testing,during delivery,neonatal care,doctor-patient communication and medical record writing.Among them,the negligence during delivery was the most prominent,with 17 cases,accounting for 37.0%,and 12 of these cases(26.1%)were caused by"delay in decision to transfer to cesarean section";the negligence in the neonatal care process was the second,with 15 cases,accounting for 32.6%,and 9 of these cases(30.8%)were caused by the non-standardization of the neonatal resuscitation process(NRP).The analysis of the correlation between hospital grades and main types of negligence showed that among the 12 cases with delayed decision to transfer to cesarean section,10 cases(30.3%)occurred in tertiary hospitals and 2 cases(15.4%)occurred in secondary hospitals;among the 9 cases with non-standardization of NRP,5 cases(15.2%)occurred in tertiary hospitals and 4 cases(30.8%)occurred in secondary hospitals.The Fisher exact test showed that although the incidence of NRP non-standardization in secondary hospitals was higher than that in tertiary hospitals,and the incidence of delayed decision to transfer to cesarean section in tertiary hospitals was higher than that in secondary hospitals,the differences were not statistically significant(P>0.05).Conclusion The occurrence of perinatal medical malpractice is closely related to the standardization of all-round diagnosis and treatment behaviors throughout the process of prenatal,during delivery,and post-delivery.Establishing a full-cycle risk early warning mechanism,standardizing diagnosis and treatment operation procedures,and improving the emergency response capabilities of medical staff are key measures.