Monday 24 September 2018

Baby died due to 'exceptionally rare' tear in umbilical cord minutes before birth, inquest hears

The cause of the baby's death was described as 'exceptionally rare'

Coombe Hospital. Photo: Collins
Coombe Hospital. Photo: Collins

Louise Roseingrave

A baby boy died due to a tear in the umbilical cord that formed minutes before he was born, an inquest heard.

Baby Casey Lynch Byrne from Tallaght, Dublin 24 was unresponsive at birth at the Coombe Hospital, Dublin on July 10 2016. The cause of his death was described as 'exceptionally rare.'

At an inquest into his death at Dublin Coroner's Court, midwives described a large clot that covered the baby's legs at birth.

The clot was delivered with baby when he was born at 3.54am. His mother Sabrina Lynch, aged 36 at the time, had been examined upon arrival at the Coombe 44 minutes earlier and found to be in active labour.

She had a history of gestational diabetes and shoulder dystocia, where the delivery of the baby’s shoulder may require manipulation.

Midwives last detected a foetal heartbeat at 3.45am, minutes before active pushing began in the delivery suite. Ten minutes later an emergency team of paediatricians arrived to treat the infant, who was born pale and not breathing.

The baby was resuscitated and took his first spontaneous breath 16 minutes after birth. However, he had suffered significant brain damage.

Pathologist Dr Peter Kelehan said the child suffered an ‘unexplained, unpreventable natural occurrence that was exceptionally rare.’

The cause of death was acute hypovolemic shock due to blood loss as a consequence of a spontaneous tear in the umbilical vein. The torn vein was situated in the umbilical cord, which was attached to the margins of the placenta, which occurs in around 15 per cent of pregnancies.

A cord attached to the edge of the placenta can leave it more vulnerable to injury, the court heard.

“The placenta is the life support system for the baby and this continues for the full nine months of pregnancy. The best attachment for the cord is in the middle of the placenta. In baby Casey’s case it was attached to the margin, which is around 15% of pregnancies,” Dr Kelehan said.

The tear, which was unexplained, could have resulted from the baby’s own movements, the inquest heard.

“Babies can kick very hard and sometimes bruise the placenta. The baby has no sensation of hurting its placenta when it kicks it. The baby normally wouldn’t kick through a vessel like this. But the vessel was in a vulnerable place," Dr Kelehan said.

As the bleed from the tear had formed a clot, Dr Kelehan said it may have happened around ten or 15 minutes prior to delivery.

Baby Casey suffered significant brain damage due to a lack of oxygen. His parents were informed of the gravity of the situation and he was pronounced dead in their company at 10.35am on the day of his birth.

Coroner Dr Myra Cullinane returned a verdict of death due to natural causes.

“It’s very tragic. He was a perfect little baby boy and something happened in the moments before delivery which tragically he was unable to recover from,” Dr Cullinane said.

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