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Changes made at hospitals in wake of scandal

The revelation about Melissa Redmond's near tragedy prompted a series of measures by the Health Service Executive (HSE) to reduce the chances of another pregnant women almost aborting a healthy baby.

A joint letter from Dr Tony Holohan, the Department of Health's chief medical officer, and Barry White, who was in charge of patient safety in the HSE at the time, was sent to all public and private maternity hospitals in June.

It warned that they needed to put in place immediate measures to ensure that the decision to use drugs or surgical intervention in women who have been diagnosed with a miscarriage had to be approved by a consultant obstetrician.

This reduced the chance of an inexperienced junior doctor making too hasty a decision. It also led to detailed guidelines for doctors on what is best practice in this area.

The guidelines, issued by the Institute of Obstetricians and Gynaecologists in January, set out when it is necessary to repeat ultrasound scans to clarify the diagnosis of miscarriage.

The guidelines warn that if there is any doubt on the part of the sonographer, a second opinion should be sought. Emphasis must also be placed on the need to listen carefully to the views of the woman.

All maternity units in Ireland must also provide an outpatient early pregnancy assessment unit. Ultrasound machines should be of good quality and regularly checked for safety. It will be necessary to wait for the findings of the HSE report for a clearer view on just how well maintained these machines are.

It is also expected to say how well trained sonographers are. The guidelines emphasise that sonographers should be formally trained in both transabdominal and transvaginal ultrasound as both methods are complementary.

Irish Independent