A Cork woman whose son suffered life-changing injuries after a preventable pregnancy-related condition went undiagnosed has welcomed “life-saving” new guidelines and called for their swift implementation.
Laurane Foley, whose son Alex, now 12, has spastic diplegic cerebral palsy, said the HSE guidelines for the diagnosis of the relatively rare but preventable condition Vasa praevia are “great for Ireland” and has pleaded with maternity hospitals to act now.
A High Court settlement last year saw a final lump sum payment of €18m approved for Alex's care.
Vasa praevia is where blood vessels travelling from a baby to the placenta, unprotected by placental tissue or the umbilical cord, pass near the cervix.
According to the Royal College of Obstetricians and Gynaecologists, if these blood vessels tear, it can be very dangerous for the baby.
The HSE guidelines say Vasa praevia is “a preventable condition with emerging evidence of the benefits of screening”.
Led by Professor Keelin O’Donoghue, University College Cork, the guidelines specify the use of a colour doppler during fetal anatomy scans if VP risk factors are present, including carrying twins as Ms Foley was.
“When I had Alex, I had three symptoms of Vasa praevia that should have rung alarm bells, and they didn’t,” she said.
“Basically if these symptoms had been spotted, when they were giving me my ultrasound, they would have flipped the switch on the same machine to do it in colour doppler. They would have seen the blood vessels.”
A woman can then be referred for a Fetal Medicine opinion and specialised treatment.
Ms Foley said: “There are 19 maternity units in the country, and I would beg and plead with them to make sure they all implement the guidelines for the safety of all babies.
“If VP screening is done properly, then from the evidence to date it is highly accurate at approximately 99%, this can save lives.
Ms Foley said babies can be monitored and delivered by caesarean section.
“You are not going to be left alone, which is what happened to me,” she said. “I went into spontaneous labour eight weeks early and when the midwife realised I was getting tired, she broke my waters. But unfortunately when my waters broke was when Alex bled out. It was too late.”
She added: “I do know between 2011 and 2018, there were 66 baby deaths associated with VP. It might not have been the sole cause but there was some association.”
Ms Foley, who lives in Midleton, has called for training across all maternity professions.
“All clinicians involved should be aware of the risk factors and the appropriate management of VP,” she said.
“It’s not just the consultant, it’s the sonographers, it’s all of the midwives involved in the prenatal care. It takes a team to diagnose and look after us, so all clinicians should be involved in it.”
Swift access to this is recommended, based on a Trinity College Dublin study which found within 24 hours is desirable.
Vasa Praevia Support & Awareness Ireland offer support through Facebook.