ieExplains: Why the care of nine newborns at Portiuncula University Hospital is being reviewed

Obstetrician Mark Skehan is leading the new external management team sent in to Portiuncula University Hospital in Ballinasloe, Co Galway.

Why is Portiuncula University Hospital in the news?

The maternity unit at this small general hospital is located in Ballinasloe, Co Galway.

On Monday, the HSE announced that a new external management team has been sent into the unit, led by an obstetrician Mark Skehan. The team is working with the existing staff.

They are to run the unit while separate reviews into the care of nine babies at the unit continue.

The reviews are looking at two tragic cases of stillbirth from 2023, and seven cases where babies developed a condition known as HIE (hypoxic-ischemic encephalopathy). These cases date from last year and earlier this month.

Why is the HSE worried about HIE?

HIE can develop when a baby’s brain does not receive enough oxygen or blood around the time of birth — usually before, but it can also happen during birth.

If this is moderate to severe, it can result in disability including cerebral palsy or in some cases can lead to death.

Portiuncula delivers about 1,300 babies annually and would be expected to see one to two cases of HIE needing cooling treatment annually, not seven.

Concerns were also raised that six of the seven infants had to be sent for specialist cooling treatment, therapeutic hypothermia.

How is HIE treated?

Treatment essentially involves a baby’s temperature being lowered. They are placed in specialised equipment which looks like a blanket and hat.

This is “the greatest single advance in neonatology over the last 25 years” according to the National Perinatal Epidemiology Centre. The treatment “reduces the rate of death, severe disability, and lifelong cerebral palsy”, it said.

In Ireland it is only available at tertiary maternity hospitals — Cork University Maternity Hospital, and the Dublin maternity hospitals.

When will the reviews be published?

Most are expected to be done by February. However they had different starting dates so it is not yet known when all will be complete.

The HSE has said this is not a review of the maternity service at Portiuncula. It is understood the hospital will, however, look to see if any common issues arise across the findings.

In 2018 a report on 18 maternity cases including six deaths made recommendations for improvement in care at Portiuncula.