Sunday 21 January 2018

National code needed on maternity care, say doctors

Eilish O'Regan

National guidelines are needed to advise hospitals on dealing with a number of complex areas of maternity care, a conference in Dublin heard yesterday.

There are no national guidelines in place for obstetrics and gynaecology, and women with the same condition can be treated differently, depending on which hospital they attend.

Dr Chris Fitzpatrick, master of the Coombe Women's and Infant Hospital in Dublin, said guidelines were needed to help hospitals deal with cases where women wanted to refuse blood transfusion for religious reasons.

Each hospital currently has its own individual guidelines, which direct staff on how to approach these difficult cases.

In the Coombe, the patient's right to refuse a transfusion is fully respected, he added.

The conference is to hear from a Jehovah's Witness on the issue today.

A number of high-profile cases involving women refusing the treatment have come before the courts in recent years.

National guidance is also needed for rare occurrences, such as when the afterbirth adheres to the wall of the womb, leaving a woman facing severe haemorrhage or hysterectomy around the time of delivery.

Doctors currently rely on international guidelines.

"A hospital this size will only see two to three cases a year," Dr Fitzpatrick said.

"This conference allows us to share our experience to feed into those guidelines."

The conference, themed 'Towards the Development of National Guidelines for Obstetrics and Gynaecology', and organised by the Coombe and Trinity College, heard doctors also needed guidelines on the use of the drug misoprostol.

This is used where women suffer post-partum haemorrhage or miscarriage, but there are inconsistencies in the doses doctors give.

Irish Independent

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