Hospitals given guidelines after woman’s death during IVF

DECISIVE new guidelines have been issued to doctors and nurses on the care of patients receiving fertility treatment following an inquiry into the death of a young woman after a reaction to IVF treatment.

The rules, drafted by the Rotunda Hospital where the woman died, cover the diagnosis and emergency care of patients with ovarian hyperstimulation syndrome (OHSS), a disorder related to some forms of fertility treatment, including IVF.

The guidelines were signed off on by Master of the Rotunda Dr Michael Geary and the private HARI (Human Assited Reproduction Ireland) unit’s consultant Edgar Mocanu.

The guidelines include a 24-hour medical cover for patients with the disorder.

The Health Service Executive confirmed yesterday that the guidelines were sent to other hospitals. Staff have been asked to familiarise themselves with the guidelines as the numbers of complications in IVF cases could grow.

Jacqueline Rushton, 32, died in January 2003 from the rare OHSS condition following respiratory problems arising from an overreaction to the fertility treatment.

An inquiry last year into Ms Rushton’s death criticised management of her care at the Rotunda Hospital, after she was transferred there from an adjoining private IVF unit.

“It is very important for all staff in the Rotunda Hospital to become accustomed to the management of these patients, as assisted reproductive technology treatment becomes more common and so the complications of this treatment could be encountered more frequently,” the guidelines say.

Possible symptoms of OHSS include lower abdominal discomfort, vomiting, respiratory distress and rapid weight gain, the guidelines say. Enlarged ovaries and fluid build-up in the abdomen are also among the possible signs of OHSS.

The guidelines go through different stages of OHSS, including its mild, moderate and severe forms. Advice is also given on when paracentesis or the draining of a patient’s abdomen should be considered while treating the disorder.

The inquiry into Ms Rushton’s death found she would not have developed severe breathing difficulties if the fluid imbalance in her body from a negative reaction to the fertility treatment had been controlled earlier.

The family of Ms Rushton yesterday welcomed the guidelines but said they were too late. Her mother, Angela Hickey, said: “It’s just that they weren’t there when she was. They wouldn’t be there now other than for what the inquiry did.”

Jim Reilly of support group Patient Focus said: “We’ve asked these be circulated to all hospitals, public and private, to ensure what happened to Jacqueline doesn’t happen to someone else.”