{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T23:53:05Z","timestamp":1787701985830,"version":"build-2784847793"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T00:00:00Z","timestamp":1731974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The Iranian National Health Service (NHS) suggested that gynecologists face a higher risk of medicolegal claims, with a significant number of claims being related to delivery events. This study aimed to investigate the factors associated with delivery related claims.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Method<\/jats:title>\n<jats:p>In this cross-sectional study, we conducted an analysis of medico-legal documents which related to complications during delivery events and presented to Iranian Medical Legal Organization spanning from March 2018 to February 2020. A total of 227 legal prosecutions that were initiated by patients or, in cases where that wasn\u2019t possible, by their families, were included in the study and all of them were evaluated in commission with experienced professionals. The data collection phase occurred between February 2023 and May 2023. The collected data encompassed various aspects, including patient characteristics mode of delivery, reasons for claims, hospital type, accused party, the occurrence of instrumental delivery and the final disposition of the claims (paid claims or closed claims). Paid claims represent successful lawsuits where the healthcare provider or their insurer made a financial settlement to the patient. Closed claims encompass those that were either denied or dismissed. Chi-square or t-tests were employed to compare factors between paid claims and closed claims.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Result<\/jats:title>\n<jats:p>In this study, it was observed that vaginal delivery was performed in 51.1% of the claims, whereas 48.9% underwent a caesarean section.. Approximately half of the claims were against obstetrician-gynecologists, and 33% of the claims against other providers were against midwives.. The majority of complaints were related to perinatal mortality (34.8%) and neonatal asphyxia (18.5%). In 58.1% of cases, no malpractice was identified, while 41.9% resulted in paid claims. Also, there were no significant differences between the paid claims and closed claims groups in several factors, such as the type of hospital (P = 0.904), maternal age (P = 0.157), type of delivery (P = 0.080), and accused party (P = 0.168). However, the number of instrumental deliveries (13.8% of vaginal deliveries) and the reasons for claims, exhibited significant differences between the two claims (P = 0.021, P&lt;0.001 respectively).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This study found that maternal complications were more common in caesarean sections, while neonatal claims were more prevalent in vaginal deliveries. The study recommended public health interventions to reduce the overall prevalence of delivery-related claims.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0312614","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T18:26:12Z","timestamp":1732040772000},"page":"e0312614","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Analysis of medico-legal claims related to deliveries: Caesarean section vs. vaginal delivery"],"prefix":"10.1371","volume":"19","author":[{"given":"Nasim","family":"Eshraghi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjan","family":"Ghaemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Shabannejad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elham","family":"Bazmi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Foroozesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3413-3373","authenticated-orcid":true,"given":"Mohammad","family":"Haddadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sepideh","family":"Azizi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeinab","family":"Mansouri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3779-9218","authenticated-orcid":true,"given":"Sedigheh","family":"Hantoushzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,19]]},"reference":[{"issue":"1","key":"pone.0312614.ref001","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1186\/s12905-022-02065-6","article-title":"Experience of obstetricians and gynecologists in the management of medicolegal cases in Egypt","volume":"22","author":"ZK Sobh","year":"2022","journal-title":"BMC Women\u2019s Health"},{"key":"pone.0312614.ref002","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.jflm.2016.02.001","article-title":"Obstetric and gynecologic malpractice claims in Saudi Arabia: Incidence and cause","volume":"40","author":"LO AlDakhil","year":"2016","journal-title":"Journal of Forensic and Legal Medicine"},{"key":"pone.0312614.ref003","first-page":"110","article-title":"Medical malpractice in Iran: A systematic review","volume":"33","author":"P Raeissi","year":"2019","journal-title":"Med J Islam Repub Iran"},{"issue":"4","key":"pone.0312614.ref004","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1177\/00369330211052627","article-title":"National trends and cost of litigation in UK National Health Service (NHS): a specialty-specific analysis from the past decade","volume":"66","author":"J Lane","year":"2021","journal-title":"Scottish Medical Journal"},{"issue":"2","key":"pone.0312614.ref005","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ogrm.2019.11.004","article-title":"Medicolegal issues in gynaecology","volume":"30","author":"H Vickers","year":"2020","journal-title":"Obstetrics, Gynaecology & Reproductive Medicine"},{"issue":"5","key":"pone.0312614.ref006","first-page":"3161","article-title":"Obstetrics-gynecology litigation 17 years of medico-legal experience in professional liability watchdog","volume":"36","author":"M Bolcato","year":"2020","journal-title":"Acta Medica Mediterranea"},{"issue":"5","key":"pone.0312614.ref007","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18052616","article-title":"Effectiveness of Communication Interventions in Obstetrics-A Systematic Review","volume":"18","author":"S Lippke","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"pone.0312614.ref008","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ejogrb.2020.10.046","article-title":"Forensic expertise in obstetrics and gynecology\u2014Forensic expert experience","volume":"256","author":"D. 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