Coroner issues recommendations at close of baby's inquest

by Louise Rosengrave

The parents of a baby girl who died two days after birth have welcomed a coroner’s recommendation for more frequent examinations for women in high risk pregnancy.

Denise and Cathal Farrell from Nenagh, Co Tipperary planned to give birth naturally at Portiuncula Hospital in Ballinasloe, Co Galway in September 2014. However, Mrs Farrell's uterus ruptured and her baby died two days after birth. Mrs Farrell was deemed an ‘at risk labour’ because she had given birth by Cesarean section 14 months earlier.

At Dublin Coroner’s Court, the coroner made a number of recommendations including further definition of the term ‘in labour’ as Mrs Farrell’s delivery was so rapid.

“It’s been a very tough three days for us. A number of recommendations have been made and we hope they are implemented and no other family has to go through what we went through,” Mr Farrell said, speaking after the inquest.

“We are part of an overall review into maternity services at Portiuncula Hospital and we are still waiting for the publication of that report, which was due in May 2015,” he said.

The Farrells are one of 16 families involved in the independent report into maternity services at Portiuncula.

Coroner Dr Myra Cullinane returned a narrative verdict at the inquest and made recommendations to the Royal College of Obstetricians and Gynaecologists.

“I am not making a direct correlation between this and the facts of the case,” Dr Cullinane said.

The three day inquest heard that Mrs Farrell arrived at the labour ward and was admitted at 1am on September 24 2014 after her waters broke.

She was not deemed to be in established labour, despite complaints of pain and occasional contractions and there was no constant monitoring of her condition as a result.

The onset of labour had been sudden and rapid and Baby Sadhbh was born at 4.52am.

She was not breathing and was transferred to the Coombe Hospital in Dublin where she died.

Obstetrics and Gynecology registrar at Portiuncula Hospital Dr Ali Hegazy said he did not become aware Mrs Farrell had suffered a uterine rupture until she was brought to theatre for manual delivery of the placenta after the birth. Dr Hegazy said he had no reason to suspect a uterine rupture because there were no signs of it, such as vaginal bleeding, pain or shock.

Pathologist Dr Colette Adida gave the cause of death as multi-organ failure due to hypoxia due to uterine rupture but said the placenta was not available for her to examine.

Returning a narrative verdict, Dr Cullinane reiterated the importance of the availability of the placenta at post-mortem.