Baby died of brain injury days after forceps used in birth, inquest told
Published 03/09/2011 | 05:00
FORCEPS used during the delivery of a baby "most probably" caused a fracture which led to his death, an inquest heard.
Baby Daniel McGovern was eventually delivered by emergency Caesarean section at the National Maternity Hospital on Dublin's Holles Street.
A subgaleal haemorrhage -- bleeding between the skull and scalp -- was discovered shortly after his birth.
Daniel weighed 10lb 2oz when born. He was motionless following birth, a heart rate was not detected and he made no effort to breathe.
He had a significant brain injury and showed no signs of brain function, Dr Catherine Gibbons told the hearing at the City Coroner's Court in Dublin yesterday.
Daniel's mother Claire McGovern presented to the hospital on November 16, 2010, with painful contractions. She was nearly 40 weeks pregnant.
An attempt to assist a natural delivery with the use of forceps led to complications. Staff noted her baby had a slow heart rate in the womb.
Dr Declan Keane, consultant obstetrician gynaecologist at the National Maternity Hospital, told the inquest he made the decision to perform a Caesarean section after the labour failed to progress.
"I've no doubt the fracture was most probably due to forceps," he said.
He added that it would be preferable to have the delivery suite on the same floor as the operating theatre, where Caesarean sections are carried out.
The National Maternity Hospital had applied for funding to do so, but was hampered by the hospital's city centre location, the inquest heard.
Dr Simon Mills, counsel for the McGovern family, said "evidence of distress in the infant only began after attempted instrumental delivery or application of forceps".
He said that the baby's heartbeat had been normal in the run-up to the birth and had only slowed after forceps were applied.
"The only objective evidence is an instrumental delivery and injuries associated with an instrumental delivery," he added.
Daniel, of Leinster Park, Harold's Cross, Dublin, died at the National Maternity Hospital on November 23, 2010, just one week after his birth.
A post-mortem carried out by Dr Paul Downey found baby Daniel had suffered a non-depressed fracture of the skull and a subgaleal haemorrhage.
Dr Downey said that Daniel died because his brain was deprived of oxygen.
A paediatrician told the inquest he had seen a case like it just once in his 12 years of working with newborn babies.
A subgaleal haemorrhage is a very rare condition and it terrifies neonatologists as it has a very high mortality rate and is difficult to recognise, Dr Colm O'Donnell said.
Dublin city coroner Dr Brian Farrell said he needed time to consider the evidence before delivering a verdict. "I want to do justice to the situation," he said.
The case was adjourned until September 27.
Daniel's parents Ciaran and Claire McGovern have one other child, a son.