MEDICAL staff at Galway hospital had finally decided to go ahead with a termination just hours before Savita Halappanavar eventually miscarried.
The inquest heard evidence from Dr Katherine Astbury who had treated Savita throughout her pregnancy and subsequent miscarriage.
She read a statement that on Wednesday, October 23 she took the decision to go ahead with a termination because she believed there was a "real and substantial risk" to the life of Ms Halappanavar.
Only one day prior to this, on Tuesday morning, Dr Astbury had refused a termination to Ms Halappanavar on the grounds that the legal position in Ireland prevented her from doing so in her case at that time.
However, her view changed when she diagnosed sepsis had set in on Wedesday. Dr Astbury was also informed by a colleague that Savita was sweaty and having trouble breathing.
"I also informed Ms Halappanavar that if the source of the infection was not identified we would have no option but to consider termination regardless of foetal heartbeat," she said.
On Wednesday, Dr Astbury approached a colleague, Dr Geraldine Gaffney, to discuss her view that they needed to go ahead with a termination regardless of foetal heartbeat. Dr Gaffney agreed and offered to write a note to be included in the medical records to this effect.
Dr Astbury took a portable scanner back to the ward where she discovered foetal demise had already occurred. Ms Halappanavar was suffering from septic shock and Dr Astbury spoke to colleagues about moving her to ICU. Because a bed was not immediately available, Savita was taken to theatre to have an IV line inserted.
There she spontaneously delivered a female foetus. The baby had "six toes on each hand" Ms Astbury told the inquest. She asked Praveen if a chromosone analysis could be carried out in view of the extra digits.
Dr Astbury remained part of Savita's Halappanavar care during her time in ICU where it was discovered Savita had contracted e-coli. While she was on annual leave Dr Astbury was called on Saturday and informed that Savita's condition had deteriorated further and she was unlikely to survive.
Completing her testimony, Dr Astbury offered her condolences to Praveen Halappanavar and his family.