49例产前检查相关医疗损害法医学鉴定分析

Analysis on Forensic Expertise of 49 Medical Disputes in Prenatal Examination

目的从法医学鉴定的角度对涉及产前检查的医疗损害案例进行分析,探讨相关医疗损害风险及防范措施。方法对司法鉴定科学研究院及上海迪安司法鉴定有限公司2010—2017年鉴定的涉及产前检查的医疗损害共49例鉴定资料进行回顾性分析。结果近年来涉及产前检查的医疗损害鉴定案件有逐年增多的趋势。经过鉴定,有35例存在医疗过错,常见原因有未告知或告知不充分(20例),对三维、四维超声的宣传和应用不规范(14例),超声检查和血清学筛查过程不规范(12例),没有进行产前咨询(2例)等。结论医院或相关协会应通过规范化管理和操作,规避产前检查的相关风险,以便尽可能减少此类医疗损害的发生。

Objective To analyze the cases of medical disputes involving prenatal examination from a point of view of forensic expertise,and to discuss the risk of medical disputes and the preventive measures.Methods A retrospective analysis was conducted on 49 forensic expertise cases of medical disputes in prenatal examination which were identified in Academy of Forensic Science and Shanghai Di’an Forensic Science Limited Company from 2010 to 2017.Results In recent years,the number of medical disputes involving prenatal examination showed an increasing trend year by year.The common causes of medical disputes were:uninformed or insufficiently informed disclosure(20 cases);the propaganda and application of three-dimensional,four-dimensional ultrasound were not standardized(14 cases);ultrasound examination and serological screening process were not standardized(12 cases);no antenatal counseling(2 cases),etc.Conclusion In order to minimize the occurrence of such medical disputes,hospitals or related associations should avoid the risk of prenatal examination through the standardization of management and operation.