Failure to Diagnose Maternal Infection

When prenatal and intrapartum infections go unrecognized.

Maternal infections during pregnancy and labor are common, treatable, and — when missed — catastrophic. Routine prenatal care exists to screen for the infections that put mother and baby at risk. When a provider fails to test, fails to act on positive results, or fails to recognize the signs of intrauterine infection, the consequences can include neonatal sepsis, brain injury, cerebral palsy, and death.

Our birth injury team has handled cases involving missed Group B Strep, untreated urinary tract infections, undiagnosed chorioamnionitis, and other preventable infectious complications.

Infections that should be caught in prenatal care

Group B Streptococcus (GBS) — universal screening at 36–37 weeks is the standard. Untreated GBS can cause neonatal sepsis, meningitis, pneumonia, and death.
Urinary tract infections and pyelonephritis — left untreated they can trigger preterm labor and sepsis.
Sexually transmitted infections — syphilis, gonorrhea, chlamydia, HIV, and hepatitis B/C all carry vertical-transmission risk.
Cytomegalovirus (CMV) and toxoplasmosis — can cause congenital infection with hearing loss, vision loss, and developmental delays.
Listeriosis — can cause stillbirth, preterm delivery, and neonatal infection.

Intrapartum infection: chorioamnionitis

Chorioamnionitis — infection of the membranes and amniotic fluid — is the most common intrapartum infection that leads to malpractice claims. Warning signs include maternal fever, fetal tachycardia, uterine tenderness, foul-smelling amniotic fluid, and rising maternal white blood cell count. When recognized promptly, IV antibiotics and prompt delivery usually prevent serious harm. When missed, the infection can cross to the baby and cause:

Neonatal sepsis and meningitis
Brain inflammation contributing to cerebral palsy
Pneumonia and respiratory failure
Long-term neurodevelopmental impairment

How these cases go wrong

Failure to perform routine prenatal screening tests.
Positive cultures that are never communicated to the patient or acted upon.
Failure to administer intrapartum antibiotics for GBS-positive mothers.
Missing the diagnosis of chorioamnionitis despite documented maternal fever and fetal tachycardia.
Discharging a mother or newborn with untreated infection.