New guidelines on vaginal mesh and fetal anatomy scans 

Keelin O'Donoghue, senior lecturer in obstetrics at University College Cork, led the development of the guidelines. Picture: HSE

New HSE guidelines on vaginal mesh complications and fetal anatomy scans were among 12 guidelines launched on Friday to ensure the same care is available to women around the country.

Use of vaginal mesh was paused in Ireland after women highlighted life-changing negative impacts from having it inserted.

The new guidelines for doctors recommend that the impact of symptoms on “quality of life, relationships, social and occupational function” be recorded in medical notes.

They also recommend that all symptoms including “immediate and delayed post-operative symptoms” should be described and recorded.

In relation to surgery, the guidelines say if the position of the mesh or scar tissue around the mesh makes it unsafe to remove, then surgical removal should be avoided.

The new guidelines around fetal anatomy scans say all pregnant women should be offered this as “standard antenatal care”.

Women have previously highlighted limited access to these scans and referred to a “postcode lottery”. The HSE said some hospitals offer this to every pregnant woman but other hospitals can only offer it to women with higher-risk pregnancies.

The guidelines state the scan should be carried out “after 18 weeks and before 22 weeks’ gestation, ideally between 20-22 weeks’ gestation”.

Other guidelines look at management of early termination of pregnancy, recurrent miscarriage, and access to vaginal births after caesarean sections.

Keelin O’Donoghue, senior lecturer in obstetrics at University College Cork, led the development of these guidelines.

Prof O’Donoghue said they can be used by healthcare workers, patients, and policymakers to make “informed decisions” about healthcare and policy.

They are agreed between the HSE National Women and Infants Health Programme (NWIHP) and the Institute of Obstetricians and Gynaecologists of the Royal College of Physicians of Ireland (RCPI). 

Mary Horgan, president of the Royal College of Physicians of Ireland, said the guidelines will improve women’s health. Picture: HSE

RCPI president and former dean of UCC medical school Mary Horgan also addressed the launch, and said afterwards that the guidelines will improve women’s health.

NWIHP clinical director Cliona Murphy welcomed the inclusion of “plain language documents” which will make it easier for patients and doctors to share decision-making.

“These guidelines offer up-to-date, evidence-based, clinical recommendations for care of women in maternity and gynaecology services, and promote a standardised approach to care across the country,” said NWIHP.

Meanwhile, the CervicalCheck programme has secured significant funding for a new information management system.

The exact amount is “commercially sensitive”, according to information released to the Medical Independent. This shows the current system is over 20 years old and represents the “highest area of programme risk".