Lack of oxygen during delivery led to baby’s death

A BABY boy died one week after his birth by emergency caesarean section following a failed forceps delivery at the National Maternity Hospital, an inquest has heard.

Daniel McGovern was in very poor health after his birth at the hospital at Holles Street, Dublin, on November 16, 2010.

Coroner Dr Brian Farrell recorded the cause of the baby’s death as severe brain injury due to the lack of oxygen to the brain, which was in turn caused by birth trauma.

“I’m satisfied the causation is birth trauma,” said Dr Farrell.

Dublin Coroner’s Court heard Daniel suffered a prominent traumatic lesion (occipito osteodiastasis) on his head with bleeding within the skull.

A subgaleal haemorrhage, a rare type of haemorrhage, which can lead to considerable bleeding within the scalp, was detected some time after his birth.

Both conditions, occipito osteodiastasis and subgaleal haemorrhage, are very rare.

Dr Farrell said instrumental intervention, such as the use of forceps, is common to both conditions, but he said he also had to take into account other risk factors, including that the labour failed to progress, that the baby was big and was lying in an abnormal position.

“While there is no doubt a forceps is a risk factor in both of these conditions, there are other risk factors which include the failure to progress and the failure to deliver,” he said.

The inquest heard that Daniel’s mother, Claire McGovern, of Leinster Park, Harold’s Cross, Dublin, presented to the hospital on the morning of November 16, 2010, with painful contractions.

Mrs McGovern, who was on a foetal heart monitor, received an epidural at 12.40pm.

Active pushing commenced at 5.55pm.

Pushing was stopped at 6.10pm, as there was little descent of the head and the midwives decided active pushing should be stopped to allow further descent of the head over the course of an hour.

At 6.40pm, Mrs McGovern was distressed with contractions and active pushing was recommenced.

She was reviewed by a doctor an hour later with regard to a possible delivery using instruments.

Some time later a doctor attempted to deliver the baby with forceps, but after two contractions the decision was made to proceed to caesarean.

Daniel was delivered easily at 8.11pm, but his condition was poor at birth.

Daniel died at the National Maternity Hospital on November 23, 2010.

Dr Farrell expressed his condolences to the McGoverns. He recorded a narrative verdict, a summary of the facts of the case.