Saturday 23 September 2017

Labour medication increase was 'not clinically justified'

Dr Salah Abdel-Aziz Ahmed. Photo: Damien Eagers
Dr Salah Abdel-Aziz Ahmed. Photo: Damien Eagers

Liz Farsaci

An inquiry into the care of three mothers by a consultant obstetrician has heard a patient received excessive doses of a labour medication that can lead to foetal distress.

An inquiry into the care of three mothers by a consultant obstetrician has heard a patient received excessive doses of a labour medication that can lead to foetal distress.

The disciplinary hearing, held by the Medical Council in Lucan, Co Dublin, also heard that one of the babies was too high in his mother's pelvis for a vaginal birth to be possible, despite repeated attempts on the part of the doctor.

Dr Salah Aziz Ahmed faces allegations of poor professional performance and professional misconduct relating to three women who gave birth at Cavan General Hospital between November 2012 and April 2014.

Last week, the inquiry heard details involving one of the patients, a 37-year-old woman, referred to as Patient One, whose baby passed away 32 hours after he was born.

The baby was born by emergency caesarean section on the night of November 22, 2012.

It is alleged that Dr Aziz failed to start the procedure in a timely manner.

Expert witness Joanna Gillham, a consultant obstetrician based in St Mary's Hospital in Manchester, told the inquiry yesterday that the increments in which syntocinon, a labour medication, was administered to Patient One during her labour exceeded hospital guidelines.

Dr Gillham said syntocinon, a medication used during labour to strengthen and increase contractions, can be used to very good effect to help progress labour.

However, if used incorrectly, she said, it can cause foetal distress.

In the evening of November, 22 the syntocinon administered to Patient One was increased from 90mls per hour to 180mls.

This increase "was unnecessary and could lead to foetal compromise", Dr Gillham said.

Dr Aziz faces allegations regarding the dosage of syntocinon administered to Patient One.

Dr Gillham also raised concerns regarding the findings of the CTG tracing machine that monitored the baby's heart-rate throughout the afternoon and evening of November 22.

Eileen Barrington SC, representing Dr Aziz, said her client would argue the syntocinon was increased in the hope of facilitating the success of an instrumental vaginal delivery.

But Dr Gillham disagreed with this approach and, referring to the increase, said: "I cannot see it was clinically justified".

Under cross examination, Dr Gillham said she had a number of criticisms of the midwifery care provided to Patient One on the afternoon of November 22, both in regard to the administration of syntocinon and the CTG monitoring.

She said both the dilution of the syntocinon and the increments in which it was given to Patient One were not in accordance with hospital guidelines.

Dr Aziz denies the allegations against him. The inquiry continues today at the Medical Council.

Irish Independent

Editor's Choice

Also in Irish News