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Mum given contractions drug despite distress, inquest told

A WOMAN in labour at Cavan General Hospital continued to be given a drug to increase her contractions despite evidence her uterus was overstimulated and her baby was in distress, an inquest heard.

Fiona Watters, of Tara Court Square, Navan, Co Meath, subsequently gave birth to baby Jamie Flynn, who died in her arms at the Rotunda Hospital on November 24, 2012. He had been born two days earlier at the consultant-lead unit in Cavan General Hospital (CGH) suffering from a severe brain injury as a result of oxygen deprivation (hypoxia).

Returning a verdict of medical misadventure, coroner Dr Brian Farrell said hyper-stimulation of the uterus was the principal risk factor identified in the baby's death.

The inquest previously heard that CGH consultant obstetrician Dr Salah Aziz delayed doing an emergency C-section because there were no nursing staff available to man the operating theatre.

Ms Watters was initially induced on November 20. She was first seen by Dr Aziz on the morning of November 22 and he broke her waters. The baby's heart rate was monitored over the course of the day.

transferred

When Dr Aziz tried to deliver the baby using a vacuum or forceps in the labour ward, this failed and Ms Watters was transferred to theatre for C-section. The baby was born in poor condition.

Giving evidence, Dr Aziz said that there had been an abnormal reading on the baby's cardio-tachograph (CTG) earlier when Ms Watters was being given induction hormone Prostiglandin that should have been brought to a Registrar's attention. The final day of the inquest heard from the coroner's expert that there was evidence of hyper-stimulaton on the CTG as early as 4pm that afternoon, with the baby doing well up to that point.

Professor Richard Greene, consultant obstetrician at Cork University Maternity Hospital, said that it appears that Ms Watters continued to receive incrementally-increased doses of oxytocin, a drug used to increase contractions, over the following hours until after 9pm when it is then reduced.

Prof Greene said hyper-stimulation in the uterus can lead to hypoxia in babies because it reduces recovery time for blood flow to the placenta and oxygen recovery to the foetus.

"There were changes suggesting that the baby was not happy physiologically and showing signs of that in its own heartbeat" he said. The oxygen deprivation did not happen "suddenly", he told the court.

hnews@herald.ie


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