Baby died minutes after birth due to brain injury, inquest hears

A baby whose mother aired concerns for his growth during pregnancy was suffering the effects of placental disease.

Nicola Cox Coghlan from Raheny, Dublin 5 expressed concerns for her baby’s growth at 36 and 38 week scans. Her newborn baby Luke tragically died minutes after birth at the National Maternity Hospital on December 28, 2018

He suffered a brain injury due to placental disease at least 36 hours before delivery, an inquest into his death heard. Dr Declan Keane, Consultant Obstetrician at the hospital, said "it is difficult to know what could have been done differently here".

Pathologist Dr Eoghan Mooney said the placenta was smaller than average and this may relate to shallow implantation in early pregnancy. He conducted microscopic examinations of the baby’s brain at autopsy and found damage to brain cells had been an ongoing process. The baby suffered a hypoxic ischemic encephalopathy around 36 hours before delivery, the pathologist said.

“There was evidence of a fresh hemorrhage and evidence of previous hemorrhage, so this hypoxic stress was going on for a number of days,” Dr Mooney said.

Baby Luke had suffered a fetal vascular malperfusion but there was no explanation for what caused it, the inquest heard. This had been ongoing for at least seven days and explained the baby’s small size. The cause of death was brain injury due to foetal vascular malperfusion due to placental disease.

Mrs Cox Coghlan was due to attend a consultant-led clinic on December 29 but she went into labour on December 28. The baby’s heart rate was recorded at 120 beats per minute less than an hour before birth. However, 15 minutes before birth the baby’s heart rate dropped and did not recover. Baby Luke was born at 6.05am. He was pale and had no pulse. He was pronounced dead at 6.28am.

Through her legal team Nicola Cox Coghlan asked about the possibilities of expectant mothers who have a preference to be referred back to a consultant during their pregnancy.

The coroner returned a neutral, narrative verdict and said that given the increase in referrals to midwives clinics in accordance with national maternity strategy, it should be fully communicated to pregnant women that they may refer back to a consultant-led team at any time.

“It’s been very difficult for you; my deepest condolences. The story is so affecting, to hear the absolute tragedy of the loss of your very much loved and wanted baby in those circumstances,” Coroner Dr Myra Cullinane said.