Prenatal ultrasound examination for pregnant women is divided into three stages. Chart by Jiang Xuanping. Lingling is with her mother.
Reported by Xiao Xiang and Luo Qin of Huaxi Metropolis Daily, with photography.
● In the impression of Ms. Huang and her family, as long as an ultrasound examination was done, it could prevent the child from having deformities. However, they were completely unaware of the differences between prenatal diagnosis and prenatal examination, and the limitations of ultrasound examinations.
● "With the current technical conditions, no matter which method is used, even if the most famous expert conducts a thorough examination, it is impossible to guarantee the detection of all fetal malformations."
"Mommy." Lingling (a pseudonym), who is already over one year old, wobbled towards her mother. "Now she can only say this one word. We have to shout loudly for her to hear us, but I had ultrasounds at two hospitals," said Ms. Huang, Lingling's mother. If it weren't for Lingling's ear canal closure, at this age, she should have been able to learn more words.
In 2010, after living in Xinjin and becoming pregnant, Ms. Huang underwent ultrasound examinations at two hospitals, neither of which detected any fetal malformations. Not long after the baby was born, she and her husband sued the two hospitals.
The hospital stated that Ms. Huang was a high-risk older mother who underwent regular ultrasound examinations but did not undergo prenatal diagnosis, making it difficult to detect the fetus' ear deformity.
Yesterday, Ms. Huang brought her child to court.
Trusting the results of the ultrasound examination, the older mother decided to give birth to her baby.
In November 2010, Ms. Huang gave birth to Lingling via cesarean section. When the doctor brought out the child, he didn’t say a word. A few days later, when she saw her child for the first time, she realized that her daughter had malformed earlobes, closed ear canals, and defects in both hearing and appearance.
The doctor informed her that whether Lingling would regain her hearing was unknown, and the subsequent medical expenses would be very high, with just the ear canal surgery costing over 30,000 yuan.
However, during pregnancy, after undergoing an ultrasound examination at a hospital in Chengdu, she went to another hospital with prenatal diagnostic qualifications for re-examination, but no abnormalities were found. "I always believed in the results of the ultrasound examination, so I decided to have this child," said Ms. Huang, who was already 34 years old and considered a high-risk older mother. Because the ultrasound examination did not show any abnormalities, she and her husband ultimately decided to keep Lingling. After unsuccessful negotiations with the two hospitals, she and her husband filed a lawsuit, demanding compensation of 200,000 yuan.
Prenatal diagnosis might have discovered the defect, but she did not come back for follow-up.
"We actually do not have the qualification for prenatal diagnosis. After completing the ultrasound examination, we also suggested that she go to a qualified hospital for further checks," said the first hospital where Ms. Huang underwent the examination. Since only a few large hospitals in Chengdu have the capability for prenatal diagnosis, what they provided to Ms. Huang was prenatal service, including routine ultrasounds.
"At our hospital, she only underwent a regular ultrasound examination, but such examinations often fail to detect such deformities. Only stricter prenatal diagnosis may significantly affect whether a fetus should remain," said the hospital with prenatal diagnostic qualifications where Ms. Huang underwent her second examination.
The hospital’s authorized representative stated that for high-risk older mothers like Ms. Huang, hospitals usually recommend that they complete multiple rounds of examinations. For possible fetal defects, they also suggest more rigorous prenatal diagnosis, increasing the likelihood of detecting problems. On Ms. Huang's ultrasound report, there was a suggestion for follow-up, but she ultimately did not return, making prenatal diagnosis impossible.
"I am not a professional; I don't know how many times I need to check."
She and her family thought that ultrasound was the most reliable examination. How were they supposed to know that so many checks were necessary? In their impression, as long as an ultrasound examination was performed, it could prevent the child from having deformities, especially since she underwent examinations at two hospitals, one of which had prenatal diagnostic qualifications. However, they were completely unaware of the differences between prenatal diagnosis and prenatal examination, and the limitations of ultrasound examinations.
"They violated my client's right to informed consent. Such deformities can be detected through targeted ultrasound examinations," said Liu Xingpin, the authorized representative of Ms. Huang and a lawyer from Sichuan Strait Law Firm. Lingling's deformities could have been detected through specialized examinations, but the first hospital's notification letter did not propose a specific examination of the fetus' ears. Although the second hospital reminded her to follow up, Ms. Huang claimed she did not receive a follow-up schedule and was not informed that the follow-up specifically involved examining the fetus' ears.
Doctor's opinion:
Ultrasound examination is not omnipotent. Parents' expectations exceed the actual level of technology.
Considering that the child was at the age of learning to speak, Ms. Huang specially got her a hearing aid. Even so, family members had to speak loudly to get the child's attention.
After multiple unsuccessful communications with the hospital, Ms. Huang felt that she and the hospital were caught in a vicious circle: on one side, she placed extreme trust in ultrasound examinations and still did not understand the difference between prenatal examination and prenatal diagnosis. She simply thought that if the hospital conducted an examination and found no problems, it was wrong. On the other hand, the hospital repeatedly emphasized that ultrasound is not omnipotent. Targeted examinations such as ear abnormalities involve dozens of items and cannot possibly cover every item.
"With the current technical conditions, no matter which method is used, even if the most famous expert conducts a thorough examination, it is impossible to guarantee the detection of all fetal malformations," said Wu Qiong, director of the Ultrasound Imaging Diagnosis Center at Chengdu Women and Children's Hospital. Ultrasound examination is not omnipotent. Parents' expectations for ultrasound examinations often exceed the actual level of technology, frequently leading to disputes and misunderstandings about hospital work.
Currently, on all ultrasound examination reports, there is a small line at the end stating: "In most cases, fetal ears, eye contents, fingers and toes, and soft tissue abnormalities are not suitable for display." This is often overlooked by many parents. According to national data, these four items rank among the top four in terms of missed diagnoses of birth defects. Wu Qiong admitted that based on existing technical means, these four items are blind spots in ultrasound examinations.
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