Serum screening strategies to sidestep lawsuits. (Don't Forget the Obvious).

KAUAI, HAWAII -- The main reasons for lawsuits concerning maternal serum screening are all preventable, Dr. Aubrey Milunsky said at a conference on obstetrics, gynecology, perinatal medicine, neonatology, and the law.

A startling number of such lawsuits could be avoided if physicians paid more attention to some seemingly obvious screening strategies, said Dr. Milunsky, who is professor of genetics, ob.gyn., pediatrics, and pathology at Boston University.

For example, some physicians fail to offer maternal serum screening.

"I promise you, you're dead in the water if you haven't offered a screen" and the baby is born with a chromosomal or neural tube defect, he said at the meeting, which was sponsored by the university.

Dr. Milunsky then outlined steps that can help physicians manage their risk with regard to maternal serum screening. While some steps may seem obvious, each has been the basis of a lawsuit against a physician who didn't follow the advice.

* Document that the physician offered screening and the patient declined.

* Get the result. The process isn't over when the sample is sent to the screening laboratory.